A retrospective observational study of glucocorticoid-induced diabetes mellitus with IgA nephropathy treated with tonsillectomy plus methylprednisolone pulse therapy

PLoS One. 2017 May 31;12(5):e0178018. doi: 10.1371/journal.pone.0178018. eCollection 2017.

Abstract

Aims: To evaluate the incidence of GC-DM among patients with immunoglobulin A nephropathy (IgAN) and to confirm the risk factors for the development of GC-DM.

Methods: The medical records of patients with IgAN newly treated with the protocol of tonsillectomy combined with steroid pulse therapy were reviewed. The primary outcome was the development of GC-DM within the hospitalization period and during one year of follow-up.

Results: During hospitalization, 19 of the 95 patients developed GC-DM (20.0%), and the patients with GC-DM were significantly older and had a higher rate of family history of diabetes and higher HbA1c levels. The prevalence of hypertension was higher and the eGFR was numerically lower in patients with GC-DM than in those without. Older age (≥45 years) and a family history of diabetes emerged as independent risk factors for the development of GC-DM (odds ratio [OR], 6.3 and 95% confidence interval [CI], 1.6-27.6; OR, 4.4 and 95% CI, 1.2-16.6, respectively). No patients were newly diagnosed with GC-DM during 1-year observation period at out-patient clinic.

Conclusions: Among the patients with IgAN, 20% developed GC-DM during the hospitalization period, confirming the family history of diabetes is clinically necessary before starting GC therapy.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Diabetes Mellitus / chemically induced*
  • Female
  • Glomerulonephritis, IGA / complications
  • Glomerulonephritis, IGA / drug therapy*
  • Glomerulonephritis, IGA / surgery
  • Humans
  • Male
  • Methylprednisolone / adverse effects*
  • Methylprednisolone / therapeutic use
  • Retrospective Studies
  • Tonsillectomy*
  • Young Adult

Substances

  • Methylprednisolone

Grants and funding

The authors received no specific funding for this work.