Management of Hyperglycaemia and Steroid (Glucocorticoid) Therapy - Joint British Diabetes Societies - Inpatient Care Group (JBDS-IP)
This is the 3rd edition of the Joint British Diabetes Societies for Inpatient Care (JBDSIP) guideline for the management of steroid induced hyperglycaemia and steroid induced diabetes. This document is evidence-based where possible but also draws from accumulated professional knowledge and consensus agreement. A new section on care of people undergoing cancer treatment has been added. The impact that the Coronavirus pandemic has had on the use of steroids is acknowledged and a section relating to this is included.
The use of steroids in patients with established diabetes is a common clinical problem and many teams have developed their own guidelines based on the original document. Since the original JBDS guideline document was published over 10,000 downloads have been reported in the UK and the more concise version published in Diabetic Medicine was in the top 10 of article downloads in 2019. This edition will provide further evidence-based information to assist healthcare professionals working in the hospital and when reviewing people in hospital clinics and GP practices following a hospital admission.
There is no generally accepted management strategy but there is now more clarity over the impact the use of steroids can have on people already known to have diabetes and those without a previous diagnosis of the condition. Steroid induced diabetes may be frequently undiagnosed and only discovered on the emergence of symptoms or complications of acute hyperglycaemia.
This guideline constructs a framework for the recognition and management of steroid induced hyperglycaemia and steroid induced diabetes and is designed for use by general physicians. As with all of the JBDS-IP documents, this document is dynamic and will be reviewed in response to feedback with a view to incorporating emerging evidence. This document has been produced by the Joint British Diabetes Societies for Inpatient Care on behalf of Diabetes UK, the Association of British Clinical Diabetologists, (ABCD), the Diabetes Inpatient Specialist Nurse (DISN) UK Group and Training Research and Education for Nurses in Diabetes (Trend Diabetes).