Treatment of glucocorticoid- induced hyperglycemia in hospitalized patients - a systematic review and meta- analysis.
Clin Diabetes Endocrinol
; 10(1): 8, 2024 Jan 27.
Article
en En
| MEDLINE
| ID: mdl-38281042
ABSTRACT
PURPOSE:
Glucocorticoid (GC)-induced hyperglycemia is a frequent issue, however there are no specific guidelines for this diabetes subtype. Although treat-to-target insulin is recommended in general to correct hyperglycemia, it remains unclear which treatment strategy has a positive effect on outcomes. We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) to assess whether treating GC-induced hyperglycemia improves clinical outcomes.METHODS:
MEDLINE and EMBASE were systematically searched for RCTs on adults reporting treatment and outcomes of GC-induced hyperglycemia since the beginning of the data bases until October 21, 2023. Glucose-lowering strategies as compared to usual care were investigated.RESULTS:
We found 17 RCTs with 808 patients and included seven trials in the quantitative analysis. Patients with an intensive glucose-lowering strategy had lower standardized mean glucose levels of - 0.29 mmol/l (95%CI -0.64 to -0.05) compared to usual care group patients. There was no increase in hypoglycemic events in the intensively treated groups (RR 0.91, 95%CI 0.70-1.17). Overall, we did not have enough trials reporting clinical outcomes for a quantitative analysis with only one trial reporting mortality.CONCLUSION:
In GC-induced hyperglycemia, tight glucose control has a moderate effect on mean glucose levels with no apparent harmful effect regarding hypoglycemia. There is insufficient data whether insulin treatment improves clinical outcomes, and data on non-insulin based treatment regimens are currently too sparse to draw any conclusions. SYSTEMATIC REVIEW REGISTRATION Registered as CRD42020147409 at PROSPERO ( https//www.crd.york.ac.uk/prospero/ ) on April 28, 2020.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Tipo de estudio:
Clinical_trials
/
Guideline
/
Systematic_reviews
Idioma:
En
Revista:
Clin Diabetes Endocrinol
Año:
2024
Tipo del documento:
Article
País de afiliación:
Suiza