Prevention and Therapy of Steroid-Induced Diabetes

Glucocorticoids are a common cause of medication-induced diabetes mellitus (DM). Practitioners caring for patients with autoimmune blistering disease (AIBD) should be aware of this complication as glucocorticoids, more often than not, are the initial treatment for most patients with AIBD. Failure to treat glucocorticoid-induced diabetes may result in neuropathy, loss of vision, kidney failure, cardiovascular disease, and even death. Additionally, the endothelial damage that may lead to some of these sequelae can begin soon after initiating glucocorticoid therapy. There are a number of medications available to control plasma glucose levels, the choice of which will depend on individualized monitoring of glucose levels and medication side effects. Awareness of the risk factors for developing diabetes, the signs and symptoms of the disease, and the available treatment modalities will help the practitioner in treating patients safely and effectively.