Hyperglycaemia screening and management in the context of long term steroid use

Information

All patients commencing long-term corticosteroid therapy (e.g. PMR, GCA, and other conditions requiring prolonged steroid treatment) should have an HbA1c* measured before, or at the time of, treatment initiation.

Patients should also be counselled regarding the symptoms of hyperglycaemia.

• Hyperglycaemia is a potentially serious adverse effect of long-term corticosteroid therapy, particularly in older adults and those with pre-existing diabetes.
• Please refer to the screening and treatment guidance (pages 2-3).
• Provide the patient information leaflet (Appendix 1).

* HbA1c may be unreliable where red cell survival is altered e.g. untreated IDA, haemoglobinopathies, haemolytic anaemias (see Diabetes Diagnosis – RefHelp), in these situations OGTT should be used.

M.L, A.S, T.C. & M.A – 16-9-26