Format

Send to:

Choose Destination
See comment in PubMed Commons below
Ophthalmology. 2005 Mar;112(3):511-5.

Short-term tolerance of pulse methylprednisolone therapy in patients with diabetes mellitus.

Author information

  • 1Service de Médecine Interne, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, France. s.feldman@quinze-vingts.fr

Abstract

PURPOSE:

To assess the short-term tolerance of pulse methylprednisolone in patients with diabetes.

DESIGN:

Retrospective study in a national eye center.

PARTICIPANTS:

Eighty patients with type 2 diabetes, half of them also treated for hypertension, who received 3-day pulse methylprednisolone between January 1999 and December 2002 for eye disorders and were monitored according to a written protocol.

MAIN OUTCOME MEASURE:

Potentially serious side effects, serial blood glucose measurements, and hypoglycemic interventions during pulse therapy.

RESULTS:

Each pulse induced about 10 hours later a mean 2-fold peak increase of blood glucose. According to a 14-mmol/l (250 mg/dl) threshold glucose level for intervention, rapid insulin was required in 27 of 27 (100%) and 24 of 53 (45%) patients with glycosylated hemoglobin levels higher than 8% and up to 8%, respectively. In the latter group, patients older than 70 years had a 3-fold increased risk of requiring insulin. Significant side effects were systolic and/or diastolic blood pressure elevation > or = 180/110 mmHg (n = 6), ketosis without acidosis (n = 5), silent myocardial ischemia (n = 1), and disorientation (n = 1). All side effects were transient or controlled successfully by medical intervention. No infectious complication occurred during the treatment period.

CONCLUSIONS:

Pulse methylprednisolone is globally well tolerated in diabetic patients, but requires strict blood glucose and clinical monitoring.

PMID:
15745783
[PubMed - indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Elsevier Science
    Loading ...
    Write to the Help Desk