SAT-543 Incidence of Steroid Induced Diabetes Mellitus (SIDM) in Rheumatoid Arthritis (RA) Patients Managed in a Tertiary Hospital Outpatient Clinics in Manila

Abstract Disclosure: T.L. Olives: None. P.S. Puno: None. M.S. Robles: None. J.R. Sahagun: None. G.T. Zamora: None. Introduction: Steroid induced diabetes mellitus (SIDM) is a possible outcome of glucocorticoid use. Despite this, glucocorticoids remain an essential part of managing rheumatoid arthritis (RA) to achieve rapid disease control. The aim of this study was to determine the incidence of SIDM among RA patients and describe their clinical characteristics. Methodology: The authors designed a descriptive, retrospective cohort study and included patients newly diagnosed with RA without known diabetes mellitus (DM). Charts dated January 2013 to December 2023 were reviewed. Patients managed as RA, regardless of glucocorticoid use were selected in the outpatient clinics. Any participant who developed DM based on their fasting blood sugar, HbA1c or 75 g oral glucose tolerance test at any time after starting glucocorticoids will be classified as having SIDM. Results: The study population consisted of 52 Filipino adult patients, 38 were prescribed with oral glucocorticoids (70.37%). The mean (SD) age was 51.54 (+ 14.78) years with a high female preponderance (82.69%). The mean daily dosage of prednisolone equivalent over the follow-up was 6.25 mg (5 to 10 mg) and the median duration was 5 months. Most of the participants were followed up with repeat FBS revealing a mean score of 89.05 mg/dL. Only one female elderly participant was recorded to develop SIDM with a follow up FBS of 133 mg/dl after 23 months after only one month of steroid use (10mg/day). There were three female patients who developed impaired fasting glucose. Conclusion: There is a low (2.4%) prevalence of SIDM among RA patients on glucocorticoids. The average daily prednisolone dose was 6.25 mg, only slightly above the physiologic dose (5 mg). However, the lack of 75g OGTT testing may have underestimated its true prevalence, as SIDM is often detected postprandially. Researchers recommend 75g OGTT monitoring for RA patients on glucocorticoids during follow-up. Presentation: Saturday, July 12, 2025