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Steroid‐induced hyperglycemia ( SIHG ) has shown to independently increase the risk for mortality in patients with acute graft‐versus‐host disease, and it is still unclear whether  SIHG  might be a modifiable risk factor. Therefore, a feasibility trial was carried out aiming to evaluate the performance of a standardized decision support system (GlucoTab [ GT ]) for insulin therapy in patients with  SIHG . A total of 10 hyperglycemic acute graft‐versus‐host disease patients were included and treated either with  GT  or standard of care during hospitalization. Follow‐up duration was 6 months. Comparing the  GT  versus standard of care group, 364 versus 1,020 glucose readings were available during a median of 41 days (interquartile range [ IQR ] 22–89) and 101 days ( IQR  55–147) of hospitalization. The median overall glucose levels were 151 mg/ dL  (123–192) versus 162 mg/ dL  ( IQR  138–193) for  GT  and standard of care, respectively ( P  < 0.001); hypoglycemia rates were comparably low. Treatment of  SIHG  with an algorithm‐based system for subcutaneous insulin was feasible and safe.

journal of diabetes investigation

Feasibility and safety of using an automated decision support system for insulin therapy in the treatment of steroid‐induced hyperglycemia in patients with acute graft‐versus‐host disease: A randomized trial