Diabetes mellitus steroids

National High Blood Pressure Education Program noninsulin-dependent diabetes mellitus non-steroidal anti-inflammatory drug peripheral resistance... 

What is the status of the underlying medical condition Has the syndrome resolved, such as in the case of a delirium, the anxious anticipatory response to a procedure, or steroid boost for organ rejection or is the medical illness chronic (e.g., HIV or diabetes mellitus) ... 

Iwamoto T, Kagawa Y, Naito Y, et al. Steroid-induced diabetes mellitus and related risk factors in patients with neurologic diseases. Pharmacotherapy. 2004 24 508-514. 

Tosyliminothiochromone-2-carboxylates 585 are inhibitors of interleukin-1 and are thus useful for the treatment of rheumatoid arthritis, multiple sclerosis, diabetes mellitus, atherosclerosis and septic shock <1995WO9514670>, and thiochromones possessing a sulfamoyloxy side chain at either C-6 or C-7 behave as steroid sulfatase inhibitors < 1999W O9952890>. 

Corticosteroids should be used cautiously in the presence of congestive heart failure, myocardial infarction, hypertension, diabetes mellitus, epilepsy, glaucoma, hepatic disorders, osteoporosis, peptic ulceration, and renal impairment. Children are more susceptible to these adverse effects. To avoid cardiovascular collapse, steroids must be given slowly by intravenous injection. Large doses produce Cushing s syndrome (with moon face and sometimes hirsutism). 

Because side effects can complicate the use of corticosteroids, a careful history and certain tests may be advisable, particularly if a patient may require prolonged ocular therapy. Steroids should be used with great caution in patients with diabetes mellitus, infectious disease, chronic renal feilure, congestive heart feilure, and systemic hypertension. Systemic administration is generally contraindicated in patients with peptic ulcer, osteoporosis, or psychoses. Topical steroids should be used with caution and only when necessary in patients with glaucoma. 

A 64-year-old woman with insulin-dependent diabetes mellitus and pemphigus vulgaris controlled by deflaza-cort 12 mg/day was given fosinopril 10 mg/day for hypertension. Within 1 month her skin lesions worsened and an indirect immunofluorescence test became positive. Fosinopril was withdrawn and her skin lesions improved without modification of her steroid regimen 10 months later the immunofluorescence test was negative. 

The quantitative comparisons of steroid urinary profiles may reveal much useful information that is currently sought in modern biomedical research. Thus, while capillary GC/MS techniques have been used to identify the individual urinary metabolites, peak-height comparisons were shown to facilitate characterization of the steroids typical of human newborns [295], studies of various endocrinological disorders [296-299], breast cancer [300] and diabetes mellitus [268], As an example. Figure 3.18 shows a comparison of typical profile differences between normal and diabetic human males [268] briefly, peaks 2 and 3 (androsterone and etiocholano-lone) are depressed in the diabetic, while peaks 48-56 (cortisol metabolites), and peak 66 (a C2j-pentol), are characteristically elevated. 

In addition to the suppression of the hypophysial-pituitary axis and adrenal atrophy, these drugs can cause a variety of adverse effects, including osteoporosis, pancreatitis, steroid-induced diabetes mellitus, cataracts, glaucoma, psychosis, oral candidiasis and other opportunistic infections, immunosuppression, infertility, weight gain, and skin atrophy. Severe edema may also be produced, particularly in the face, depending on the degree of mineralocorticoid activity. 

Clients with diabetes mellitus may at times have a need for a steroid medication. The medication may elevate the client s glucose levels, and these levels should be monitored. The nurse would not question this medication. 

Petersen KR. Pharmacodynamic effects of oral cantiaceptive steroids cn biochem ical markers for arterial thrombosis. Studies in non-diabetic women and in women with insulin-dependent diabetes mellitus. Dan Med Bull (2001) 49,43-60. 

Urinary tract A 72-year-old woman with rheumatoid arthritis, secondary amyloidosis, and steroid-induced diabetes mellitus, who was taking glucocorticoids and low-dose methotrexate, developed an emphysematous pyelonephritis [76 ]. 

---