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Steroid‐induced diabetes mellitus in systemic lupus erythematosus patients: analysis from a M alaysian multi‐ethnic lupus cohort
Author(s) -
Shaharir Syahrul Sazliyana,
Gafor Abdul Halim Abdul,
Said Mohd Shahrir Mohamed,
Kong Norella C. T.
Publication year - 2015
Publication title -
international journal of rheumatic diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.795
H-Index - 41
eISSN - 1756-185X
pISSN - 1756-1841
DOI - 10.1111/1756-185x.12474
Subject(s) - medicine , systemic lupus erythematosus , diabetes mellitus , cohort , ethnic group , lupus erythematosus , immunology , dermatology , endocrinology , disease , antibody , sociology , anthropology
Objective Systemic lupus erythematosus ( SLE ) is a chronic autoimmune disease and glucocorticoid is the mainstay of treatment in SLE . The reported incidence of steroid‐induced diabetes mellitus ( SDM ) ranged between 1–53%. We sought to investigate the prevalence and associated factors of SDM in patients with SLE . Methodology A total of 100 SLE patients attending the Nephrology/ SLE and Rheumatology Clinic, Universiti Kebangsaan Malaysia Medical Centre ( UKMMC ) who received corticosteroid treatment were recruited. The diagnosis of diabetes mellitus was based on the 2010 American Diabetes Association's criteria. Prevalent cases of SDM were also included. Statistical analysis was performed to determine the factors associated with SDM . Results Thirteen of them (13%) developed SDM , with the median onset of diagnosis from commencement of glucocorticoid treatment being 8 years (range 0.5–21 years). Although only seven Indians were recruited into the study, three of them (42.9%) had SDM compared to Malays (9.3%) and Chinese (12.8%) ( P ≤ 0.05). Univariate and multivariate analysis showed that higher numbers of system or organ involvement in SLE , abdominal obesity, hypertriglyceridemia and daily prednisolone of ≥ 1 mg/kg/day were the important associated factors of SDM ( P ≤ 0.05). Meanwhile, hydroxychloroquine ( HCQ ) use was associated with reduced SDM prevalence ( P < 0.05). Conclusion The prevalence of SDM among SLE patients was 13% and Indians were more prone to develop SDM compared to other races. Higher numbers of system involvement, abdominal obesity, hypertriglyceridemia and the use of oral prednisolone of ≥ 1 mg/kg/day were associated with SDM , while HCQ use potentially protects against SDM .