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Prednisolone Disturbs Carbohydrate Metabolism

FRIDAY, May 17 (HealthDay News) -- In patients with inflammatory diseases without diabetes, treatment with low-dose prednisolone has deleterious effects on carbohydrate metabolism, according to a study published online May 13 in Diabetes Care.

Carolyn J. Petersons, M.B.B.S., from Flinders University in Adelaide, Australia, and colleagues examined carbohydrate metabolism in nine subjects (mean age, 59 years) with inflammatory rheumatologic disease without diabetes mellitus before and after a seven- to 10-day course of oral prednisolone (6 mg daily). Carbohydrate metabolism was also examined in 12 subjects (mean age, 61 years), also with inflammatory rheumatologic disease without diabetes mellitus, using continuous long-term prednisolone (mean, 6.3 mg per day).

The researchers found that acute prednisolone treatment significantly increased basal endogenous glucose production (EGP), significantly reduced insulin suppression of EGP, significantly reduced peripheral glucose disposal, and significantly reduced both first-phase and second-phase insulin secretion. Continuous long-term prednisolone treatment significantly attenuated insulin suppression of EGP and non-oxidative glucose disposal while having no significant effect on basal EGP, insulin secretion, and adipose tissue areas.

"Our findings demonstrate that low-dose prednisolone exerts a major deleterious effect on carbohydrate metabolism," Petersons and colleagues conclude. "When prescribing glucocorticoids, careful consideration should be given to these potential adverse metabolic effects, and alternative anti-inflammatory agents should be considered."

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