{"id":29972,"date":"2026-09-16T09:17:39","date_gmt":"2026-09-16T08:17:39","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/refhelp\/?page_id=29972"},"modified":"2026-10-23T14:44:10","modified_gmt":"2026-10-23T13:44:10","slug":"hyperglycaemia-screening-and-management-in-the-context-of-long-term-steroid-use","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/hyperglycaemia-screening-and-management-in-the-context-of-long-term-steroid-use\/","title":{"rendered":"Hyperglycaemia screening and management in the context of long term steroid use"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\"><strong>Information<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>All patients commencing long-term corticosteroid therapy<\/strong> (<em>e.g. PMR, GCA, and other conditions requiring prolonged steroid treatment<\/em>) should have an <strong>HbA1c* measured before, or at the time of, treatment initiation<\/strong>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Patients should also be counselled regarding the symptoms of hyperglycaemia.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Hyperglycaemia is a potentially serious adverse effect of long-term corticosteroid therapy, particularly in older adults and those with pre-existing diabetes.<\/li>\n\n\n\n<li>Please refer to the screening and treatment guidance (pages 2-3).<\/li>\n\n\n\n<li>Provide the patient information leaflet (Appendix 1).<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">* <em>HbA1c may be unreliable where red cell survival is altered e.g. untreated IDA, haemoglobinopathies, haemolytic anaemias (see<\/em> <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/diabetes\/diabetes-diagnosis\/\" target=\"_blank\" rel=\"noreferrer noopener\"><em>Diabetes Diagnosis \u2013 RefHelp<\/em><\/a><em>), in these situations OGTT should be used.<\/em><\/p>\n\n\n\n<div data-wp-interactive=\"core\/file\" class=\"wp-block-file\"><object data-wp-bind--hidden=\"!state.hasPdfPreview\" hidden class=\"wp-block-file__embed\" data=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Screening-and-monitoring-steroid-diabetes.pdf\" type=\"application\/pdf\" style=\"width:100%;height:600px\" aria-label=\"Embed of Screening and monitoring steroid diabetes.\"><\/object><a id=\"wp-block-file--media-83972855-f26f-410c-9e0d-340c247e97ca\" href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Screening-and-monitoring-steroid-diabetes.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Screening and monitoring steroid diabetes<\/a><a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Screening-and-monitoring-steroid-diabetes.pdf\" class=\"wp-block-file__button wp-element-button\" download aria-describedby=\"wp-block-file--media-83972855-f26f-410c-9e0d-340c247e97ca\">Download<\/a><\/div>\n\n\n\n<div data-wp-interactive=\"core\/file\" class=\"wp-block-file\"><object data-wp-bind--hidden=\"!state.hasPdfPreview\" hidden class=\"wp-block-file__embed\" data=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Algorithm-Hyperglycaemia.pdf\" type=\"application\/pdf\" style=\"width:100%;height:600px\" aria-label=\"Embed of Algorithm Hyperglycaemia.\"><\/object><a id=\"wp-block-file--media-09493213-b9ad-4a39-bbc3-2e10ec482e47\" href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Algorithm-Hyperglycaemia.pdf\">Algorithm Hyperglycaemia<\/a><a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Algorithm-Hyperglycaemia.pdf\" class=\"wp-block-file__button wp-element-button\" download aria-describedby=\"wp-block-file--media-09493213-b9ad-4a39-bbc3-2e10ec482e47\">Download<\/a><\/div>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>M.L, A.S, T.C. &amp; M.A &#8211; 16-9-26<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<div class=\"wp-block-getwid-tabs\" data-active-tab=\"0\"><ul class=\"wp-block-getwid-tabs__nav-links\"><\/ul>\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Resources and Links<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p class=\"wp-block-paragraph\">Lothian Steroid Bundle &#8211; to be updated<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Gliclazide-tablets-for-steroid-induced-diabetes-PIL-260424.pdf\" target=\"_blank\" rel=\"noopener\">Gliclazide tablets for steroid induced diabetes<\/a><\/p>\n<\/div><\/div>\n<\/div>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n","protected":false},"excerpt":{"rendered":"<p>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. * HbA1c may be unreliable where red cell survival is altered e.g. untreated IDA, haemoglobinopathies,<\/p>\n","protected":false},"author":20,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_searchwp_excluded":"","footnotes":""},"categories":[919],"class_list":["post-29972","page","type-page","status-publish","hentry","category-https-apps-nhslothian-scot-refhelp-management-of-long-term-high-steroid-therapy"],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"mariamazoysaavedra","author_link":"https:\/\/apps.nhslothian.scot\/refhelp\/author\/mariamazoysaavedra\/"},"rttpg_comment":0,"rttpg_category":" <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/category\/endocrinology\/https-apps-nhslothian-scot-refhelp-management-of-long-term-high-steroid-therapy\/\" rel=\"tag\">Management of long term high steroid therapy<\/a>","rttpg_excerpt":"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. * HbA1c may be unreliable where red cell survival is altered e.g. untreated IDA, haemoglobinopathies,","_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/29972","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/users\/20"}],"replies":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/comments?post=29972"}],"version-history":[{"count":9,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/29972\/revisions"}],"predecessor-version":[{"id":30556,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/29972\/revisions\/30556"}],"wp:attachment":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/media?parent=29972"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=29972"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}