Steroid-Induced Hyperglycemia in Rheumatoid Arthritis: A Case Report

<p class="p1"><strong><span class="s1">Background:</span></strong> Steroid-induced hyperglycemia is a common side effect of steroid therapy,<br /> such as prednisone, used in the treatment of various conditions, including rheumatoid arthritis. Elevated blood glucose levels characterize this metabolic disturbance(steroid-induced hyperglycemia), which can pose challenges in patient management, particularly in those without prior diabetes history. <p class="p1"><strong><span class="s1">Aim:</span></strong> The authors present the case of a 58-year-old female with rheumatoid arthritis who developed hyperglycemia after initiating prednisone therapy. It aimed to illustrate the clinical course, management, and outcomes of steroid-induced hyperglycemia in this patient. <p class="p1"><strong><span class="s1">Clinical details:</span></strong> The patient, with a history of rheumatoid arthritis, received a short-term course of prednisone due to worsening symptoms. Within a week, she developed symptoms of hyperglycemia despite no prior history of diabetes. Laboratory tests confirmed elevated blood glucose levels and a glycated hemoglobin of 8.5%. Her blood glucose remained elevated, despite dietary modifications and oral hypoglycemic agents, requiring insulin therapy. <p class="p1"><strong><span class="s1">Outcomes</span>:</strong> Insulin therapy initiation with a basal-bolus regimen led to gradually recovering blood glucose levels. Regular monitoring and adjustments resulted in stable fasting and postprandial glucose levels within target ranges. The patient reported symptom improvement and increased energy levels. <strong><span class="s1">Conclusion:</span></strong> This case highlights the importance of vigilant monitoring and management of steroid-induced hyperglycemia in patients receiving steroid therapy, even for short durations. Collaborative efforts between rheumatology, endocrinology teams, and clinical pharmacists were crucial in ensuring optimal disease control while minimizing long-term steroid use. Individualized treatment plans and patient education are essential for optimizing outcomes and reducing risks associated with steroid-induced hyperglycemia.