Clinical determinants of insulin requirements during treatment of prednisolone-induced hyperglycaemia
Authors' conclusion
In patients with prednisolone-associated hyperglycaemia, calculating insulin doses based on sex, HbA1c, diabetes status and regular diabetes treatment and weight may improve glycaemic control compared to weight-based dosing.
Study context
- Population
- Hospitalised adult inpatients taking prednisolone ≥20 mg/day with hyperglycaemia; 24-h IV insulin infusion
- Participants
- 50 inpatients
- Outcome
- Associations between daily insulin dose (required to attain mean glucose 8 mmol/L) and clinical variables
Main finding
As reported in the abstract
Determinants of daily insulin dose
- Univariate: weight associated with daily insulin dose (r2 = 0.11)
- p = 0.024
- Multivariate model (sex, HbA1c, prior DM diagnosis, DM treatment, weight) explained nearly two thirds of variability in daily insulin dose (r2 = 0.65)
- p < 0.001
Observational data: associations, not effects.
Further findings
Baseline characteristics
- Age, years (mean ± SD)
- 69 ± 10
- Daily prednisolone dose, mg
- 34 ± 10
- HbA1c
- 7.7 ± 2.0 % (61 ± 10 mmol/mol)
- Known T2D
- 77 %
- Female
- 30 %
Original publication
Clinical determinants of insulin requirements during treatment of prednisolone-induced hyperglycaemia. Diabetes Res Clin Pract. Published 1 February 2023. doi:10.
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