Abstract

DRUG INDUCED HYPERGLYCEMIA - A CASE REPORT

Gluco-Corticoid (GC) induced hyperglycemia is detrimental and that intensive glycemic management during GC therapy could improve clinical outcomes. Hyperglycemia is clinically defined as a serum glucose level > 180 mg/dl that persists for more than 2 hours. Unlike hypoglycemia, acute hyperglycemia is often benign and may persist without any clinically significant signs or symptoms. It is well known and recognized that gluco-corticoid use in people with or without diabetes results in hyperglycemia. Corticosteroids blunt the action of insulin and promote hepatic gluco-neogenesis, possibly by activation of liver x receptor-β involving phosphoenolpyruvate carboxykinase gene transcription.There are a number of mechanisms by which hyperglycemia occurs. Corticosteroids reduce glucose utilization, increase glucose production, inhibit the effects of insulin on myocytes and adipocytes, and increase hepatic glucose release. The effects can be seen as early as 12 hours after beginning therapy. This is a case report of Betamethasone (Betnesol) induced hyperglycemia in a 50 yr old male patient who has taken the drug as OTC. The reaction due to Betnesol was found to be probable according to NARANJO’S causality assessment.