Current smoking and new-onset diabetes mellitus during high-dose glucocorticoid treatment in the collagen vascular diseases

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: SUN 807-838-Diabetes - Diagnosis, Complications & Outcomes
Clinical
Sunday, June 16, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board SUN-818
Ichiro Tatsuno*1, Tomoaki Tanaka2 and Takashi Terano3
1Toho University Sakura Medical Center, Sakura-City, Japan, 2Chiba University Graduate School of Medicine, Chiba, Japan, 3Chiba Aoba Municipal Hosp, Chiba, Japan
Objective. Although high-dose glucocorticoids are known to cause new-onset diabetes mellitus (glucocorticoid-induced diabetes mellitus; GIDM) within a short period, its risk factors have remained to be determined. We investigated the risk factors related to GIDM diagnosed within 2 months in collagen vascular diseases.

Methods. A total of 2631 patients with collagen vascular diseases was registered between 1986 and 2006 in the Chiba-Shimoshizu Rheumatic Cohort. We analyzed 681 patients newly treated with high-dose glucocorticoid, who did not have DM and/or its previous diagnosis (age: 46.3±16.7 years, PSL dose: 40.0±14.1 mg/day). GIDM was diagnosed by two or more glucose measurements in patients with fasting glycaemia >7 mmol/l and 120 min post-load glycaemia >11.1 mmol/l.

Results. GIDM was observed in 26.3% within 2 months, and the GIDM group had higher age, higher BMI, lower rates of females and systemic lupus erythematosus, higher rates of smoking, alcohol use and microscopic polyangiitis in comparison with non-GIDM. Multivariate logistic regression analysis demonstrated that the risk of GIDM was independently higher in every 10-year increment of initial age with adjusted odds ratio (OR) 1.556 (95% confidence interval: 1.359-1.783), in every one kg/m2 increment of BMI with OR 1.062 (1.002-1.124), in current smoking with OR 1.664 (1.057-2.622), and in every 10 mg increment of initial dose of prednisolone with OR 1.250(1.074-1.454).

Conclusion. High-dose glucocorticoids caused GIDM with high prevalence within a short period, and current smokers should be considered at higher risk of GIDM in addition to age, BMI, and initial dose.

Tatsuno I, Sugiyama T, Suzuki S, Yoshida T, Tanaka T, Sueishi M, et al. Age-dependent early complication of symptomatic vertebral fracture with high-dose glucocorticoid in treatment for collagen vascular diseases. J Clin Endocrinol Metab. 2009;94(5):1671-7. Tatsuno I, Sugiyama T. Glucocorticoid-induced diabetes mellitus is a risk for vertebral fracture during glucocorticoid treatment. Diabetes Res Clin Pract. 2011;93(1):e18-20.

Nothing to Disclose: IT, TT, TT

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