Steroid diabetes mellitus is a pathological condition in which the level of corticosteroids in the blood rises, leading to impaired carbohydrate metabolism. This disease is accompanied by all clinical manifestations characteristic of hyperglycemia. As a rule, such a pathology has an easier course than the DM of the first or second type. In the overwhelming majority of cases, with the right treatment, it is possible to stabilize the condition of the sick person. However, amid elevated glucose levels, there is a likelihood of developing diabetic angiopathy. Other possible complications include diabetic neuropathy, atherosclerotic vascular disease, and much more.
There is no exact data on how widespread steroid diabetes is among the population. Men and women are almost equally affected by the development of this pathology.
As we have said, steroid diabetes occurs as a result of the fact that the level of hormones produced by the adrenal cortex increases significantly in the blood. There are two main groups of causes that may contribute to the development of such a disease. First of all, these are various endocrine pathologies leading to an increase in the functional activity of the adrenal glands. The most prominent example is Itsenko-Cushing’s disease, accompanied by a lesion of the hypothalamic-pituitary system, followed by hypersecretion of adrenocorticotropic hormone and secondary hyperfunction of the adrenal cortex. Among these patients, the prevalence of steroid hyperglycemia is about twelve percent.
In addition, often the formation of this pathological process leads to tumors localized in the adrenal glands. In this case, those tumors that are capable of independently producing corticosteroids, for example, aldosterone , are mainly meant . Both of the above causes lead to the development of endogenous steroid diabetes mellitus.
As a separate nosological unit, hyperglycemia was identified, due to the long-term administration of corticosteroid drugs. Often this pathological condition is self-suppressed after the medications have been canceled. A number of studies were conducted, during which it was found that when taking prednisone at a dosage of forty milligrams for at least two days, approximately fifty-four percent of people had at least one episode of hyperglycemia. This pathological process is also called drug-induced diabetes.
The main risk group for its occurrence is people suffering from various autoimmune pathologies. Corticosteroids are prescribed for many other diseases. According to statistics, such a violation is detected in about twelve percent of people with systemic lupus erythematosus. When you take hydrocortisone in the dosage of one hundred and twenty milligrams, the risk of developing this disease increases more than tenfold. Based on the foregoing, it can be concluded that the intake of corticosteroids should be carried out only under the supervision of a physician.
The formation mechanism of steroid sugar diabetes quite complicated. It is known that corticosteroids can influence metabolism. Under their influence, proteins begin to decay more actively, they are released from more tissues amino acids. There is intense deposition of glycogen in the liver cells. Occurring biochemical processes lead to increased glucose synthesis. Over time, there is a defeat of the beta cells of the pancreas, which helps to reduce insulin production.
Symptoms of steroid diabetes
As we have said, the symptoms in this pathological process do not have any specificity. However, as a rule, they are not as intensely expressed as in the diabetes of the first or second type. First of all, a sick person pays attention to the fact that he has increased thirst. The volume of liquid consumed per day increases significantly, in some cases it reaches five or more liters. However, despite heavy drinking, dry mouth almost does not subside.
Against the background of the violations occurring, such a symptom as the urge to urinate increases. The volume of daily urine reaches three or four liters. In childhood, involuntary urination is possible at night. The patient complains of fatigue, drowsiness and causeless irritability. His appetite increases, but his weight remains almost unchanged. Often the clinical picture is complemented by a headache.
There are characteristic symptoms and appearance. The skin of a sick person becomes very dry. Nail plates exfoliate and break, and hair falls out. Often there are sensitive disorders in the lower or upper extremities.
Diagnosis and treatment of the disease
Diagnosis of this disease begins with the collection of complaints and anamnesis. It is imperative to assess the level of glucose, including using the glucose tolerance test. Additionally, the level of corticosteroids is determined, an ultrasound study of the adrenal glands, computed tomography, and so on are carried out .
Initially, for the treatment of steroid diabetes, it is necessary to identify and eliminate its cause. Therapy of the main disease is prescribed; medications are canceled with the medicinal form. In parallel, medical correction of hyperglycemia is carried out, for example, with the help ofhypoglycemic drugs. Also of great importance is a special low-carb diet.
Prevention of steroid diabetes
Principles prophylaxis come down to the timely detection and treatment of Itsenko-Cushing’s disease, tumors located in the adrenal region. It is necessary to prescribe dosage forms of corticosteroids only under strict indications, to observe the recommendations for their reception, as well as monitor the level of glucose during this therapy.