"从治疗到挑战:探索类固醇诱发的糖尿病--综合案例研究"。

Krishna Upadhye, Uttam Kumar Aggarwal
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引用次数: 0

摘要

类固醇诱发的糖尿病(SIDM)是一项重大的临床挑战,它是糖皮质激素治疗的结果,常用于各种疾病。临床医生希望减轻免疫系统反应引起的炎症,通常会处方类固醇。然而,类固醇治疗的一个明显副作用是患者的血糖水平会升高。尽管类固醇具有抗炎和免疫抑制的作用,因此被广泛使用,但 SIDM 仍是一种常见且可能有害的并发症,临床实践中必须慎重考虑。可的松和泼尼松是最常用的两种类固醇,它们会增加肝脏产生葡萄糖的能力,降低细胞对胰岛素的敏感性。本病例研究强调了早期发现和有效管理 SIDM 的必要性,强调了个体化治疗策略的重要性。此外,本病例研究还强调了在了解与类固醇使用相关的高血糖对临床发病率和死亡率的影响方面存在的差距,敦促制定综合指南,以预防并发症并优化高血糖状态下的患者预后。本病例的研究对象是一名 53 岁的女性,在被诊断为肾病综合征后,她被处方注射甲基强的松龙。服药后,她的血糖水平明显升高,这符合类固醇诱发糖尿病的典型表现。本病例研究探讨了类固醇与糖尿病之间的复杂关系,阐明了糖皮质激素诱发高血糖的机制。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
"FROM TREATMENT TO CHALLENGE: EXPLORING STEROID-INDUCED DIABETES MELLITUS – A COMPREHENSIVE CASE STUDY."
Steroid-induced diabetes mellitus (SIDM) represents a significant clinical challenge, arising as a consequence of glucocorticoid therapy commonly used in various medical conditions. Clinicians who want to reduce inflammation caused by immune system reactions commonly prescribe steroids. However, one significant side effect of steroid treatment is that patients' blood sugar levels rise. Long-term steroid use raises the risk of acquiring diabetes mellitus. Despite the widespread use of steroids for their anti-inflammatory and immunosuppressive properties,SIDM remains a common and potentially harmful complication that necessitates careful consideration in clinical practice. Two of the most often given steroids, cortisone and prednisone, increase the liver's ability to produce glucose and reduce cells' sensitivity to Insulin. This case study underscores the need for early detection and effective management of SIDM, emphasizing the importance of individualized treatment strategies.Furthermore,it highlights the gaps in understanding the impact of hyperglycemia associated with steroid use on clinical morbidity and mortality,urging for comprehensive guidelines to prevent complications and optimize patient outcomes in the context of the hyperglycemic state. The subject of this case study is a 53-year-old woman who was prescribed injections of methylprednisolone after being diagnosed with nephrotic syndrome. Her blood sugar levels noticeably increased after taking this medicine, which is consistent with the classic presentation of steroid-induced diabetes mellitus. This case study explores the complex relationship between steroids and diabetes mellitus, elucidating the mechanisms underlying hyperglycemia induced by glucocorticoids.
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