Novel approaches to manage glucocorticoid-induced diabetes in hospital inpatients
The effects of liraglutide vs insulin on glycaemic control in inpatients with glucocorticoid-induced diabetes
Alfred Hospital
30 participants
May 29, 2014
Interventional
Conditions
Summary
High dose steroids can raise blood glucose levels. These can cause infections, prolong hospital stay and even rarely result in death. Little is known about the best way to manage patients with ‘steroid diabetes’. We will study various approaches to manage high glucose levels in patients treated with steroids in hospital. We will use minimally invasive continuous glucose monitoring, a contemporary technology, to compare and evaluate in detail two different treatment schedules. One intervention will combine longer acting and mealtime insulin (conventional regimen), and the other will combine liraglutide, a newer non-insulin injection, together with longer acting insulin. The results of this study will provide important objective pilot data on management of patients with ‘steroid diabetes’ in hospital.
Eligibility
Inclusion Criteria2
- Glucocorticoid-induced or exacerbated diabetes treated with insulin and/or oral glucose-lowering medication(s)
- Glucose >= 15 mmol/l
Exclusion Criteria9
- Type 1 diabetes
- Admission to intensive care
- Likely to require surgical intervention
- Likely to be admitted <48 h
- eGFR <15 ml/min
- Acute vomiting or history of gastroparesis
- Known allergy to insulin or GLP-1 agonists
- Proliferative retinopathy
- Premenopausal females
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Interventions
Basal insulin (0.2 U/kg by subcutaneous injection in the morning) + liraglutide (0.6 mg by subcutaneous injection in the morning) for 72 h
Locations(1)
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ACTRN12615000333516