Dose–Response Association Between Systemic and Dermatologic Glucocorticoid Use and Type 2 Diabetes Mellitus: A Nationwide Case–Control Study
Authors' conclusion
Systemic and dermatologic glucocorticoid use was associated with a clear dose-dependent increase in Type 2 diabetes mellitus odds, including at doses < 2.5 mg/day. Other topical routes appeared metabolically safe.
Study context
- Population
- People aged ≥40 years with incident T2D and matched controls, Danish registry data 2013–2021matched 1:3
- Participants
- 149,113 vs 447,339
- Exposure
- Systemic and topical glucocorticoid use vs no use, by daily prednisolone-equivalent dose
- Casesn = 149,113
- Controlsn = 447,339reference
- Outcome
- Odds of T2D by glucocorticoid exposure (≥1 prescription within 1 year before diagnosis and ≥2 within 3 years) and daily prednisolone-equivalent dose
Methodological detailsregistry-based, matched 1:3 by age, sex and weighted Charlson Comorbidity Index, conditional logistic regression
- Registry-based
- Matched 1:3 by age, sex and weighted Charlson Comorbidity Index
- Conditional logistic regression
Main finding
As reported in the abstract
Odds of T2D by oral systemic glucocorticoid dose
Adjusted odds ratio (95% CI)
Oral systemic <2.5 mg/day
1.25(1.21–1.29)
Oral systemic 2.5-7.4 mg/day
1.49(1.43–1.56)
Oral systemic ≥7.5 mg/day
3.02(2.90–3.15)
Observational data: associations, not effects.
Further findings
Odds of T2D by dermatologic glucocorticoid dose
| OR (95% CI) | ||
|---|---|---|
| Dermatologic <2.5 mg/day | 1.21 (1.18–1.23) | |
| Dermatologic ≥7.5 mg/day | 1.51 (1.40–1.63) | |
| 0.512Odds ratio (log scale) |
Nasal, rectal, ophthalmic or otic glucocorticoids
- No progressively significant associations after adjustment
Original publication
Dose–Response Association Between Systemic and Dermatologic Glucocorticoid Use and Type 2 Diabetes Mellitus: A Nationwide Case–Control Study. Diabetes Obes Metab. Published 16 June 2026. doi:10.
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