Association between the Duration of Steroid Therapy with Hyperglycemia in Patients with Systemic Lupus Erythematosus (SLE)
Downloads
Introduction: Systemic Lupus Erythematosus (SLE) is a systemic autoimmune disease which primary treatment consists of steroid drugs administration. Prolonged steroid administration is often associated with an increase in blood glucose, a condition known as hyperglycemia. Hence, this study aimed to evaluate the association between the duration of steroid therapy with hyperglycemia in patients with SLE treated at a tertiary healthcare center in Surabaya, Indonesia.
Methods: A cross-sectional study was conducted under a purposive sampling frame from January to December of 2022 by utilizing secondary data from electronic medical health records in Dr. Soetomo General Academic Hospital, a tertiary healthcare center in Surabaya, Indonesia. The association between variables were analyzed using Fisher's exact test, chi square test, independent T-test, one-way ANOVA, Mann-Whitney, and Spearman's rank correlation.
Results: Out of 150 included patients, 2.67% experienced hyperglycemia following steroid therapy for SLE. There were no significant associations between clinical variables and hyperglycemia occurence in SLE patients (p>0.05). Patients that received higher doses of steroid did not experience any significant difference in hyperglycemia (p=0.727 for <6 months; p=0.865 for ≥6 months). Daily steroid dose was also not significantly associated with the severity of SLE manifestations based on the SLEDAI score (p=0.081). Overall, no significant association was identified between the duration of steroid therapy with hyperglycemia among SLE patients in the hospital (p=0.365).
Conclusion: The study found no significant correlation between clinical variables, hyperglycemia incidence, daily steroids dosage, methylprednisolone dosage, SLE severity, or steroid use duration in patients with Systemic Lupus Erythematosus.
Aviana F and Birawan IM. 2021. Efek Samping steroid sistemik pada terapi pemgus vulgaris. Cermin Dunia Kedokteran 48(9):330-334. DOI: https://doi.org/10.55175/cdk.v48i9.117.
Bohari B, Nuryani N, Abdullah R, Amaliah L, Hafid F. 2021. Hubungan aktivitas fisik dan obesitas sentral dengan hiperglikemia wanita dewasa: Cross- sectional study. AcTion: Aceh Nutrition Journal 6(2):199-206. DOI: http://dx.doi.org/10.30867/action.v6i2.587.
Chia CW, Egan JM, Ferrucci L. 2018. Age-related changes in glucose metabolism, hyperglycemia, and cardiovascular risk. Circulation research 123(7):886-904. doi: 10.1161/CIRCRESAHA.118.312806.
European Medicines Agency (EMEA). (2010). Guideline on clinical investigation of medicinal products used in the treatment of osteoarthritis. Available at https://www.ema.europa.eu/en/documents/scientific-guideline/guideline-clinical-investigation-medicinal-products-used-treatment-osteoarthritis_en.pdf.
Hernández D, Rodríguez A, Rufino M, Lorenzo V, de Bonis E, González-Posada JM, Torres A. 1997. High incidence of steroid complications related to cumulative steroid dose in systemic lupus erythematosus patients over the age of 50. Geriatric Nephrology and Urology 6:141-147.
Hanim R, Darusman HS, Rahminiwati M. 2018. Studi karakteristik tipe diabetes pada tikus (Rattus novergicus) yang diinduksi deksametason. Jurnal Veteriner Maret 19(1):1-10. DOI:10.19087/jveteriner.2018.19.1.1.
Imran S, Thabah MM, Azharudeen M, Ramesh A, Bobby Z, Negi VS, Negi V. 2021. Liver abnormalities in systemic lupus erythematosus: a prospective observational study. Cureus 13(6):e15691. doi: 10.7759/cureus.15691.
Indonesian Rheumatology Association. 2019. Diagnosis dan Pengelolaan Lupus Eritematosus Sistemik. Jakarta: Perhimpunan Reumatologi Indonesia.
Kasturi S and Sammaritano LR. 2016. Corticosteroids in Lupus. Rheumatic Diseases Clinics of North America 42(1): 47–viii. https://doi.org/10.1016/j.rdc.2015.08.007.
Lin YJ, Chien CC, Ho CH, Chen HA, Chen CY. 2022. Increased risk of type 2 diabetes in patients with systemic lupus erythematosus: A nationwide cohort study in Taiwan. Medicine 101(51):e32520. doi: 10.1097/MD.0000000000032520.
Lucky MA. 2021. Asuhan keperawatan pada pasien diabetes mellitus dengan masalah keperawatan ketidakstabilan kadar glukosa darah (Hiperglikemia). Ponorogo: Universitas Muhammadiyah Ponorogo.
Malau SR. 2014. Hubungan Kadar Glukosa Darah Puasa dengan Profil Lipid pada Diabetes Melitus Tipe 2. Medan: Universitas HKBP Nommensen.
Manson SC, Brown RE, Cerulli A, Vidaurre CF. 2009. The cumulative burden of oral corticosteroid side effects and theeconomic implications of steroid use. Respiratory Medicine 103(7):975-994. doi: 10.1016/j.rmed.2009.01.003.
Maulana MR and Kuswarini S. 2022. Risk analysis of ast and alt level in patients with diabetes mellitus type 2. Jaringan Laboratorium Medis 4(1):51-55.
Saputra SI, Berawi KN, Susianti S, Hadibrata E. 2023. Hubungan diabetes melitus dengan kejadian gagal ginjal kronik. Medical Profession Journal of Lampung 13(5):787-791.
Sihombing B and Vegas A. 2016. Penggunaan Steroid Pada Geriatri. Jakarta: Balai Penerbit FKUI.
Tamez-Pérez HE, Quintanilla-Flores DL, Rodríguez-Gutiérrez R, González-González JG, Tamez-Peña AL. 2015. Steroid hyperglycemia: prevalence, early detection and therapeutic recommendations: a narrative review. World Journal of Diabetes 6(8):1073-1081. doi: 10.4239/wjd.v6.i8.1073.
Trilistyoati D, Agustina B, Awalia A. 2021. Clinical profile and incidence of infection in systemic lupus erythematosus patients at medical inpatient installation, Department of Internal Medicine, dr. soetomo general academic hospital, Surabaya, Indonesia in 2016. Majalah Biomorfologi 31(2):49. https://doi.org/10.20473/mbiom.v31i2.2021.49-56.
Wardani IS. 2023. Steroid induced diabetes mellitus. Jurnal Kedokteran Unram 12(1):1372-1376. https://doi.org/10.29303/jku.v12i1.852.
Yuliadi PE and Mochtar C. 2014. Hiperglikemia dan hubungannya dengan fungsi ginjal pada pasien dengan batu ginjal. Jurnal kedokteran 1(2).
Zhou B, Xia Y, She J. 2020. Dysregulated serum lipid profile and its correlation to disease activity in young female adults diagnosed with systemic lupus erythematosus: a cross-sectional study. Lipids in Health and Disease 19(1):1-6. doi: 10.1186/s12944-020-01232-8.
Copyright (c) 2024 Farahdiva Audrey Widyanrika, Sony Wibisono Mudjanarko, Maftuchah Rochmanti, Deasy Ardiany, Putu Bagus Dharma Permana
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Copyright (c) Author
1. The journal allows the author to hold the copyright of the article without restrictions.
2. The journal allows the author(s) to retain publishing rights without restrictions.
3. The formal legal aspect of journal publication accessibility refers to Creative Commons Atribution-Share Alike 4.0 (CC BY-SA).