Crimson Publishers Publish With Us Reprints e-Books Video articles


Modern Applications in Pharmacy & Pharmacology

Management of Steroid-Induced Hyperglycemia with a DPP-4 Inhibitor

  • Open or Close Laura K Triantafylidis*1, Chelsea Hawley2, John Roefaro3 and Susan Holden1

    1 Primary Care Clinical Pharmacy Specialist, VA Boston Medical Center, USA

    2 PGY-2 Geriatrics Pharmacy Resident, VA Boston Medical Center, USA

    3 Geriatrics Clinical Pharmacy Specialist, Geriatrics Pharmacy Residency Program Director, VA Boston Medical Center, USA

    *Corresponding author: Laura K Triantafylidis, PharmD, Primary Care Clinical Pharmacy Specialist , VA Boston Medical Center, USA, 151 S. Huntington Ave, Jamaica Plain, MA 02130

Submission: March 08, 2018; Published: March 26, 2018

DOI: 10.31031/MAPP.2018.02.000526

ISSN 2637-7756
Volume2 Issue1


Purpose: Demonstrate use of a DPP-4 inhibitor to manage steroid-induced hyperglycemia in an older adult with steroid-induced hyperglycemia.

Summary: Guidelines recommend insulin for the management of steroid-induced hyperglycemia. Oral options are often more favorable given the ability to avoid administration of insulin injections and an increased risk of hypoglycemia, however supporting evidence is lacking. An 86- year-old, white male with Type 2 Diabetes Mellitus, previously well controlled on metformin mono therapy, had an A1C increase of 2% after 3 months of oral prednisone. Saxagliptin 5mg daily was added, after 4 months of dual oral therapy, the patients A1C returned to baseline; a decrease from 10.1% to 7.8%. During this period, the patient was maintained on an average dose of prednisone 10mg daily and no significant changes were made to diet or exercise habits.

Conclusion: Conclusion:

Key Points

a. Current guidelines suggest the use of insulin for the management of steroid-induced hyperglycemia which may be less favorable for older adults.

b. DPP-4 inhibitors have a glucose dependent mechanism of action and low risk for hypoglycemia making them a preferable option in older adults.

c. DPP-4 inhibitors have demonstrated efficacy for the management of steroid-induced hyperglycemia when used in conjunction with metformin.

Get access to the full text of this article