Steroid induced diabetes

Glucocorticoids are potent inducers of insulin resistance. Steroid induced diabetes is therefore an iatrogenic form of T2DM. The mainstay of treatment is insulin therapy.

Full blood count

An FBC is part of the baseline investigations of any newly diagnosed patient with diabetes.

U+Es, LFTs

A full biochemical profile is a mandatory investigation in any newly presenting case of diabetes.

OGTT

An oral glucose tolerance test (OGTT) is not necessary if the patient’s fasting glucose is greater than 7 mmol/L, or the random is greater than 11 mmol/L, but otherwise a standard 75 g two hour OGTT should be performed after an overnight fast.

Fasting lipid profile

A fasted total cholesterol, HDL cholesterol and triglycerides should be part of the baseline investigations.

ECG

Not normally necessary but may be performed if there is suspicion of pre-existing ischaemic heart disease.

HbA1c

This is a useful baseline but at present is not a diagnostic criteria.

Auto antibodies

GAD and anti-islet cell antibodies should only be tested if there is some suspicion that the patient has T1DM presenting in a steroid treated patient.

C-peptide levels

This is rarely a useful test in steroid induced diabetes but may be contributory if there is some suspicion that the patient actually has T1DM.

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