Risk factors and management of corticosteroid-induced hyperglycaemia in paediatric acute lymphoblastic leukaemia

Pediatr Blood Cancer. 2020 Feb;67(2):e28085. doi: 10.1002/pbc.28085. Epub 2019 Nov 17.

Abstract

Corticosteroids are incorporated into protocols for the treatment of acute lymphoblastic leukaemia, and hyperglycaemia is a recognised side effect. Corticosteroids exert their hyperglycaemic effect with a multifactorial mechanism. Complications of hyperglycaemia include an increased risk of infection - bacterial, viral and fungal. Approximately half of the children who develop corticosteroid-associated hyperglycaemia are predicted to require insulin treatment, with age and obesity having found to be predictive factors. Fasting and random glucose values can be used to define hyperglycaemia. This review focuses on the published evidence for significant predictive factors for the development of corticosteroid-induced hyperglycaemia and provides guidance on management.

Keywords: acute lymphoblastic leukaemia; corticosteroids; hyperglycaemia; insulin.

Publication types

  • Review

MeSH terms

  • Adrenal Cortex Hormones / adverse effects*
  • Child
  • Disease Management
  • Humans
  • Hyperglycemia / chemically induced*
  • Hyperglycemia / pathology
  • Hyperglycemia / therapy*
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy*
  • Risk Factors

Substances

  • Adrenal Cortex Hormones