J Diabetes Investig. 2019;10(2):339-342.
Steroid-induced hyperglycemia (SIHG) has shown to independently increase the risk for mortality in patients with acute graft-versus-host disease, and it is still unclear whether SIHG might be a modifiable risk factor. Therefore, a feasibility trial was carried out aiming to evaluate the performance of a standardized decision support system (GlucoTab [GT]) for insulin therapy in patients with SIHG. A total of 10 hyperglycemic acute graft-versus-host disease patients were included and treated either with GT or standard of care during hospitalization. Follow-up duration was 6 months. Comparing the GT versus standard of care group, 364 versus 1,020 glucose readings were available during a median of 41 days (interquartile range [IQR] 22-89) and 101 days (IQR 55-147) of hospitalization. The median overall glucose levels were 151 mg/dL (123-192) versus 162 mg/dL (IQR 138-193) for GT and standard of care, respectively (P < 0.001); hypoglycemia rates were comparably low. Treatment of SIHG with an algorithm-based system for subcutaneous insulin was feasible and safe.
Felix Aberer (1), Julia K Mader (1), Julia Holzgruber (1), Christian Trummer (1), Verena Schwetz (1), Marlene Pandis (1), Peter N Pferschy (1), Hildegard Greinix (2), Norbert J Tripolt (1), Thomas R Pieber (1, 3, 4), Armin Zebisch (2), Heinz Sill (2), Albert Wölfler (2, 3), Harald Sourij (1, 3)
- Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria.
- Division of Hematology, Medical University of Graz, Graz, Austria.
- Center for Biomarker Research in Medicine (CBmed), Graz, Austria.
- Health-Institute for Biomedicine and Health Sciences, Graz, Austria.