What Is Medically Induced Diabetes?

Prednisone And Diabetes: What Is The Connection?

Prednisone is a steroid that works in a similar way to cortisol, which is the hormone normally made by the body's adrenal glands. Steroids are used to treat a wide range of conditions from autoimmune disorders to problems related to inflammation, such as arthritis. They work by reducing the activity of the body's immune system and reducing inflammation and so are useful in preventing tissue damage. However, steroids may also affect how the body reacts to insulin, a hormone that controls the level of sugar in the blood. Contents of this article: How do steroids affect blood sugar levels? Steroids can cause blood sugar levels to rise by making the liver resistant to the insulin produced by the pancreas. When blood sugar levels are high, insulin is secreted from the pancreas and delivered to the liver. When insulin is delivered to the liver, it signals it to reduce the amount of sugar it normally releases to fuel cells. Instead, sugar is transported straight from the bloodstream to the cells. This process reduces the overall blood sugar concentration. Steroids can make the liver less sensitive to insulin. They can make the liver carry on releasing sugar even if the pancreas is releasing insulin, signalling it to stop. If this continues, it causes insulin resistance, where the cells no longer respond to the insulin produced by the body or injected to control diabetes. This condition is called steroid-induced diabetes. Steroid-induced diabetes Diabetes is a condition that causes a person's blood sugar level to become too high. There are two main types of diabetes: Type 1 diabetes: in which the pancreas fails to produce any insulin. Type 2 diabetes: in which the pancreas fails to produce enough insulin, or the body's cells fail to react to the insulin produced. Steroid-induce Continue reading >>

Drug Induced Diabetes

RESEARCH SHOWS MANY MEDICATIONS ACTUALLY INDUCE DIABETES A large number of studies are now showing that Many widely prescribed medications can predispose a person to develop type 2 diabetes or can actually precipitate diabetes. This incidence, especially increases when pre-existing risk factors are present. A vast majority of medications may act by increasing insulin resistance, by diminishing the secretion of insulin, or both. Widely Used Medications Linked With Causing Diabetes Thiazide diuretics (HydroDIURIL-hydrochlorothiazide or Lozol-indapamide) are a type of diurectic, used to treat high blood pressure by increasing your water excretion (elimination). They cause the kidneys to pass more fluid into the urine. Along with water, diuretics cause the excretion or loss of many minerals through the urine, especially potassium. These diuretics revolutionized the treatment of hypertension in the 1960s, but were soon noted to increase the risk of diabetes. Research revealed that decreased potassium levels are directly linked with developing Type 2 Diabetes. Beta blockers such as atenolol should no longer be prescribed, according to the guidelines from the National Institute for Clinical Excellence. Medications, like, metoprolol (Lopressor, Toprol XL), Nadolol (Corgard) and atenolol (Tenormin) impair insulin release. Several studies have linked chronic use of -blockers with an increased risk for the development of diabetes. In fact the research revealed that Beta-blockers increase diabetes risk by 50%. Cholesterol lowering medications, like Lipitor, Crestor, Zocor, Simvastatin, Atorvastatin-to name a small few have been linked with causing an increased risk for developing diabetes by 26 times. This risk is even in the absence of any other predisposing factors like obesity. Continue reading >>

Drug-induced Hypoglycemic Coma In 102 Diabetic Patients

Background Hypoglycemic coma is a continuous threat for diabetic patients treated with insulin and/or oral hypoglycemic agents; it may be associated with substantial morbidity and mortality. Methods We retrospectively reviewed our clinical experience with drug-induced hypoglycemic coma during a 7-year period. Results The study consisted of 102 patients and included 61 females and 41 males. The median age was 72 years. Ninety-two patients suffered from type 2 diabetes mellitus; 10 patients had type 1 diabetes mellitus. The median lowest blood glucose level was 1.77 mmol/L (32 mg/dL). Drug-induced hypoglycemic coma occurred in 99 patients out of the hospital, while 3 patients developed it during hospitalization. Drug-induced hypoglycemic coma occurred in patients undergoing treatment with insulin, glyburide, and combined therapy with insulin and glyburide, insulin and metformin, or glyburide and metformin. Ninety-three patients had at least 1 of the following risk factors: age older than 60 years, renal dysfunction, decreased intake of energy, and infection. Fourteen patients concomitantly received drugs that potentiated hypoglycemia. Forty patients responded to treatment within the first 12 hours, while 62 patients had protracted hypoglycemia of 12 to 72 hours' duration. Morbidity included physical injuries in 7 patients, myocardial ischemia in 2 patients, and stroke in 1 patient. Death occurred in 5 patients. Conclusions Hypoglycemic coma is a serious and not an uncommon problem among elderly patients with diabetes mellitus and treated with insulin and/or oral hypoglycemic drugs. Risk factors contribute substantially to the morbidity and mortality of patients with drug-induced hypoglycemic coma. Enhanced therapeutic monitoring may be warranted when hypoglycemic drugs ar Continue reading >>

Steroid Diabetes

Steroid diabetes (also "steroid-induced diabetes") is a medical term referring to prolonged hyperglycemia due to glucocorticoid therapy for another medical condition. It is usually, but not always, a transient condition. Medical conditions[edit] The most common glucocorticoids which cause steroid diabetes are prednisolone and dexamethasone given systemically in "pharmacologic doses" for days or weeks. Typical medical conditions in which steroid diabetes arises during high-dose glucocorticoid treatment include severe asthma, organ transplantation, cystic fibrosis, inflammatory bowel disease, and induction chemotherapy for leukemia or other cancers. Insulin[edit] Glucocorticoids oppose insulin action and stimulate gluconeogenesis, especially in the liver, resulting in a net increase in hepatic glucose output. Most people can produce enough extra insulin to compensate for this effect and maintain normal glucose levels, but those who cannot develop steroid diabetes. Criteria[edit] The diagnostic criteria for steroid diabetes are those of diabetes (fasting glucoses persistently above 125 mg/dl (7 mM) or random levels above 200 mg/dl (11 mM)) occurring in the context of high-dose glucocorticoid therapy. Insulin levels are usually detectable, and sometimes elevated, but inadequate to control the glucose. In extreme cases the hyperglycemia may be severe enough to cause nonketotic hyperosmolar coma. Treatment[edit] Treatment depends on the severity of the hyperglycemia and the estimated duration of the steroid treatment. Mild hyperglycemia in an immunocompetent patient may not require treatment if the steroids will be discontinued in a week or two. Moderate hyperglycemia carries an increased risk of infection, especially fungal, and especially in people with other risk factors s Continue reading >>

Drug Induced Diabetes Insipidus

Diabetes insipidus is often characterized by excessive thirst and excessive urination. This causes many people to experience dehydration over time, though dipsogenic diabetes insipidus may actually cause excessive hydration. In many instances, ADH suppression is caused by physical changes that have occurred in the central nervous system or the kidneys. It may be caused by a trauma, illness, or tumor in most circumstances. It may also be caused by certain medications that an individual may be taking for an unrelated condition. Drug induced diabetes insipidus will cause the same symptoms as any other form of DI. Over time, if the medication is taken continuously despite the physical symptoms, it is possible for drug induced diabetes insipidus to turn into nephrogenic or central diabetes insipidus. What Drugs Can Cause Diabetes Insipidus? Lithium is the most common medication that causes diabetes insipidus. This is because it affects the flow of sodium through the muscle and nerve cells in the body. It is often used to treat bipolar disorder, especially if an individual suffers from periodic episodes of mania. These additional medications are also known to cause diabetes insipidus as a side effect in some individuals. Amphotericin B: This medication is prescribed for individuals who are suffering from a serious fungal infection. It can also be used to treat leishmaniasis, which is caused by a parasite that is spread by certain biting sandflies. Known as Fungizone or Mysteclin-F, kidney problems are a common side effect with this injectable drug. Cidofovir: Also known as Vistide, this is an antiviral medication that is used to treat CMV retinitis when a patient has been diagnosed with AIDS. It can only be distributed through an intravenous formulation. Demeclocycline: This Continue reading >>

Steroid/drug-induced Hyperglycemia

OVERVIEW: What every practitioner needs to know Drug-induced hyperglycemia is a more common complication of various treatment regimens than many physicians may realize. - Glucocorticoid (GC) or steroid-induced hyperglycemia has been well described in rheumatology, oncology and transplant literature for several decades. GC-induced hyperglycemia is the most common form of drug-induced hyperglycemia. GC treatment routes include oral, IV, intranasal, inhaled, topical, and localized injections. While all forms of GC administration carry the risk of diabetes, the oral and IV routes are by far the most commonly associated with hyperglycemia and will thus be the only treatment routes described in this chapter. GCs may be the most diabetogenic of all drugs known to induce hyperglycemia. - L-Asparaginase induced hyperglycemia has also been well known to complicate acute lymphocytic leukemia (ALL) induction therapy, particularly in children. - Tacrolimusand cyclosporine (calcineurin inhibitors - CNI) are also diabetogenic. In transplant patients, tacrolimus is more likely to result in hyperglycemia, especially in pediatric transplant recipients and African Americans, and is estimated to be 5 times as diabetogenic as cyclosporine. - In both transplant and oncology patients, GCs, in addition to either L-asparaginase or tacrolimus, has resulted in significantly higher rates of hyperglycemia than seen with any of the agents alone. Because diabetes in transplant patients is unlikely to be due to one factor, the condition has been given a new name, NODAT (New Onset Diabetes After Transplant). - More recently, hyperglycemia has been shown to be associated with a typical or second generation antipsychotic (SGA) use, particularly in conjunction with weight gain. The risk of hyperglycemia Continue reading >>

Drug-induced Diabetes.

Abstract The only drugs which commonly cause diabetes during therapeutic use are the anti-hypertensive vasodilator diazoxide, and corticosteroids in high doses such as those used to palliate intracranial tumours. Thiazide diuretics have in the past been used in higher doses than necessary to treat hypertension, and the lower doses now used probably carry only a slight risk of inducing diabetes. The risk from beta-blockers is also quite small, but there is some evidence that thiazides combined with beta-blockers may be more likely to cause diabetes than either drug alone. The combination is probably best avoided in patients with a family history of non-insulin-dependent diabetes. The effect of the low-oestrogen combined oral contraceptive pill seems to be slight, and it presents a risk only to women who have had gestational diabetes. Bodybuilders who take enormous doses of anabolic-androgens can develop impaired glucose tolerance. Several drugs, including theophylline, aspirin, isoniazid and nalidixic acid can cause transient hyperglycaemia in overdosage, but only streptozotocin, alloxan and the rodenticide Vacor are likely to cause permanent diabetes. Continue reading >>

Drug-induced Diabetes

Many therapeutic agents can predispose to or precipitate diabetes, especially when pre-existing risk factors are present, and these may cause glucose control to deteriorate if administered to those with existing diabetes. They may act by increasing insulin resistance, by affecting the secretion of insulin, or both. For convenience, these agents may be subdivided into widely used medications that are weakly diabetogenic, and drugs used for special indications that are more strongly diabetogenic. Examples of the former include antihypertensive agents and statins, and examples of the latter include steroids, antipsychotics and a range of immunosuppressive agents. There are also a number of known beta cell poisons including the insecticide Vacor, alloxan and streptozotocin. Introduction A wide range of therapeutic agents may affect glucose tolerance, and the list of known or suspected drugs is lengthy. This entry summarizes evidence concerning the agents most frequently implicated. Widely used medications A number of drugs used to reduce cardiovascular risk also predispose to the development of diabetes. These include the thiazide diuretics, beta-blockers and statins. It should however be appreciated that these are commonly offered to individuals who are at increased risk of diabetes by virtue of risk factors such as obesity and hypertension, and that risk association does not necessarily mean causation. Thiazides: Thiazide diuretics revolutionized the treatment of hypertension in the 1960s, but were soon noted to increase the risk of diabetes[1]. Subsequent experience showed that that this risk is greatly reduced by low-dose therapy, whose benefits therefore outweigh its risks. The thiazides have a weak inhibitory effect upon release of insulin from the beta cell. This eff Continue reading >>

Medicationinduced Diabetes Mellitus

Department of Pediatrics, University of Virginia, Charlottesville Corresponding Author: David R. Repaske, Department of Pediatrics, University of Virginia, Charlottesville, VA ( Department of Pediatrics, University of Virginia, Charlottesville Corresponding Author: David R. Repaske, Department of Pediatrics, University of Virginia, Charlottesville, VA ( Please review our Terms and Conditions of Use and check box below to share full-text version of article. I have read and accept the Wiley Online Library Terms and Conditions of Use. Use the link below to share a full-text version of this article with your friends and colleagues. Learn more. Epidemiological studies and case reports have demonstrated an increased rate of development of diabetes mellitus consequent to taking diverse types of medication. This review explores this evidence linking these medications and development of diabetes and presents postulated mechanisms by which the medications might cause diabetes. Some medications are associated with a reduction in insulin production, some with reduction in insulin sensitivity, and some appear to be associated with both reduction in insulin production and insulin sensitivity. A variety of medications have been associated with development of diabetes. Establishing a precise cause and effect relationship between a medication and development of diabetes is challenging for several reasons. Side effects of most medications are rare and clinical studies of medications typically evaluate effectiveness and are not powered to evaluate side effects. Diabetes is a common disease and there is always a question of whether it would have developed if the person had not taken the medication in question. Patients are often taking multiple medications and so it is hard to determine w Continue reading >>

8 Drug-induced Diabetes

Volume 6, Issue 4 , October 1992, Pages 849-866 Author links open overlay panel R.E.Ferner Get rights and content The only drugs which commonly cause diabetes during therapeutic use are the anti-hypertensive vasodilator diazoxide, and corticosteroids in high doses such as those used to palliate intracranial tumours. Thiazide diuretics have in the past been used in higher doses than necessary to treat hypertension, and the lower doses now used probably carry only a slight risk of inducing diabetes. The risk from -blockers is also quite small, but there is some evidence that thiazides combined with -blockers may be more likely to cause diabetes than either drug alone. The combination is probably best avoided in patients with a family history of non-insulin-dependent diabetes. The effect of the low-oestrogen combined oral contraceptive pill seems to be slight, and it presents a risk only to women who have had gestational diabetes. Bodybuilders who take enormous doses of anabolic-androgens can develop impaired glucose tolerance. Several drugs, including theophylline, aspirin, isoniazid and nalidixic acid can cause transient hyperglycaemia in overdosage, but only streptozotocin, alloxan and the rodenticide Vacor are likely to cause permanent diabetes. Continue reading >>

Drug-induced Diabetes Mellitus

Get access/doi/pdf/10.1517/14740338.4.6.1097?needAccess=true Aims: To review the medications that influence glucose metabolism with a focus on hypertensive, transplant and HIV-infected patient populations. Methods: Literature obtained from a MEDLINE search from 1970 to present, including studies published in the English language. The search strategy linked drugs, hyperglycaemia and diabetes mellitus, HIV, transplantation, hypertension and psychiatric patients. Results: Many common therapeutic agents influence glucose metabolism. Multiple mechanisms of action on glucose metabolism exist through pancreatic, hepatic and peripheral effects. The prevalence of hyperglycaemia was higher with the use of thiazide diuretic, -blocker, calcineurin, protease inhibitors and atypical antipsychotic drugs. Conclusions: Patients treated with those drugs appear to be at increased risk for developing diabetes. It is prudent to monitor plasma glucose values when it is not possible to avoid prescription of medication with known effects on carbohydrate metabolism. Continue reading >>

Drug Induced Diabetes

Tweet A number of medications have side effects which include the raising of blood glucose levels. Drug induced diabetes is when use of a specific medication has lead to the development of diabetes. In some cases the development of diabetes may be reversible if use of the medication is discontinued, but in other cases drug-induced diabetes may be permanent. Drug induced diabetes is a form of secondary diabetes, in other words diabetes that is a consequence of having another health condition. Which drugs can induce diabetes? A number of drugs have been linked with an increased risk development of type 2 diabetes. Corticosteroids Thiazide diuretics Beta-blockers Antipsychotics Is diabetes permanent? Diabetes may not be permanent but this can depend on other health factors. With some medications, blood glucose levels may return back to normal once the medication is stopped but, in some cases, the development of diabetes may be permanent. Managing drug induced diabetes If you need to continue taking the medication that has brought on diabetes, it may make your diabetes more difficult to control than would otherwise be the case. If you are able to stop the course of medication, you may find your blood glucose levels become slightly easier to manage. Following a healthy diet and meeting the recommended exercise guidelines will help to improve your chances of managing your blood glucose levels. Can drug induced diabetes be prevented? It may be possible to reduce the risk of developing diabetes by ensuring you to keep to a healthy lifestyle whilst you are on the medication. Being on smaller doses of the medication or shorter periods of time may help to reduce the likelihood of developing high blood sugar levels and diabetes. Doctors will usually try to put you on the smallest e Continue reading >>

8 Drug-induced Diabetes

Volume 6, Issue 4 , October 1992, Pages 849-866 Author links open overlay panel R.E.Ferner Get rights and content The only drugs which commonly cause diabetes during therapeutic use are the anti-hypertensive vasodilator diazoxide, and corticosteroids in high doses such as those used to palliate intracranial tumours. Thiazide diuretics have in the past been used in higher doses than necessary to treat hypertension, and the lower doses now used probably carry only a slight risk of inducing diabetes. The risk from -blockers is also quite small, but there is some evidence that thiazides combined with -blockers may be more likely to cause diabetes than either drug alone. The combination is probably best avoided in patients with a family history of non-insulin-dependent diabetes. The effect of the low-oestrogen combined oral contraceptive pill seems to be slight, and it presents a risk only to women who have had gestational diabetes. Bodybuilders who take enormous doses of anabolic-androgens can develop impaired glucose tolerance. Several drugs, including theophylline, aspirin, isoniazid and nalidixic acid can cause transient hyperglycaemia in overdosage, but only streptozotocin, alloxan and the rodenticide Vacor are likely to cause permanent diabetes. Continue reading >>

Drug Or Chemical Induced Diabetes Mellitus W/o Complications

ICD-10: E09.9 Short Description: Drug or chemical induced diabetes mellitus w/o complications Long Description: Drug or chemical induced diabetes mellitus without complications This is the 2018 version of the ICD-10-CM diagnosis code E09.9 Valid for Submission The code E09.9 is valid for submission for HIPAA-covered transactions. Code Classification Endocrine, nutritional and metabolic diseases (E00–E90) Diabetes mellitus (E08-E13) Drug or chemical induced diabetes mellitus (E09) Convert to ICD-9 Synonyms Diabetes mellitus caused by drug without complication Diabetes mellitus caused by non-steroid drugs Diabetes mellitus caused by non-steroid drugs without complication Drug-induced diabetes mellitus Drug-induced diabetes mellitus Steroid-induced diabetes Steroid-induced diabetes mellitus without complication Diabetes Also called: DM, Diabetes mellitus Diabetes is a disease in which your blood glucose, or blood sugar, levels are too high. Glucose comes from the foods you eat. Insulin is a hormone that helps the glucose get into your cells to give them energy. With type 1 diabetes, your body does not make insulin. With type 2 diabetes, the more common type, your body does not make or use insulin well. Without enough insulin, the glucose stays in your blood. You can also have prediabetes. This means that your blood sugar is higher than normal but not high enough to be called diabetes. Having prediabetes puts you at a higher risk of getting type 2 diabetes. Over time, having too much glucose in your blood can cause serious problems. It can damage your eyes, kidneys, and nerves. Diabetes can also cause heart disease, stroke and even the need to remove a limb. Pregnant women can also get diabetes, called gestational diabetes. Blood tests can show if you have diabetes. One t Continue reading >>

Drug-induced Glucose Alterations Part 2: Drug-induced Hyperglycemia

A variety of pharmacological agents A variety of pharmacological agents affect glucose homeostasis resulting in either hypo- or hyperglycemia. Hormones such as insulin, glucagon, catecholamines, growth hormone, and cortisol, among others, contribute to normoglycemia. Drug-induced serum glucose alterations manifested as hyperglycemia or hypoglycemia can have perpetual effects on the body, particularly in patients with diabetes. This article is the second of a two-part series reviewing drug-induced serum glucose alterations. The first article in the series appeared in the previous issue of this journal (Diabetes Spectrum 24:171-177, 2011). In this article, we review select therapies commonly contributing to the development of hyperglycemia. Hyperglycemia is clinically defined as a serum glucose level > 180 mg/dl that persists for more than 2 hours. Unlike hypoglycemia, acute hyperglycemia is often benign and may persist without any clinically significant signs or symptoms; however the development of diabetic ketoacidosis (DKA) or hyperosmolar hyperglycemic state (HHS) are hyperglycemic emergencies. Often signs and symptoms of hyperglycemia manifest when serum glucose levels are in the range of 270–360 mg/dl for an extended period and include the classical symptoms of polyphagia, polydipsia, and polyuria (Table 1). Untreated hyperglycemia, when accompanied with excretion of ketones in urine (DKA), is a medical emergency more common in people with type 1 diabetes. It results in the following symptoms: fatigue, weakness, fruity odor of the breath, confusion, lack of concentration, shortness of breath, nausea and vomiting, dry skin, and flushing of the skin. People with type 2 diabetes are more likely to develop HHS, formerly known as hyperosmolar hyperglycemic nonketotic c Continue reading >>