Frequency and risk factors for steroid-induced diabetes in pemphigus vulgaris patients in Razi Hospital, Tehran

Pemphigus vulgaris is the most common autoimmune blistering disease. Prednisone، commonly in combination with an immunosuppressive adjuvant such as azathioprine or cyclophosphamide، is the standard treatment for pemphigus vulgaris. Approximately 5% to 15% of mortality of the disease is due to the complications of corticosteroids therapy. The aim of this study was to determine the prevalence and risk factors of steroid-induced diabetes in pemphigus patients hospitalized in Razi hospital، Tehran in 2009 and 2010.

In this cross-sectional study، 177 first-time admitted pemphigus vulgaris patients were studied regarding presence of risk factors for steroid-induced diabetes. Those risk factors were included age، sex، blood pressure، body mass index (BMI)، family history of diabetes، medications used before and after initiation of treatment، fasting blood sugar (FBS)، triglyceride (TG) high density lipoprotein (HDL)، low density lipoprotein (LDL) levels at the time of admission، and three weeks after the treatment was started.

Twenty-nine patients (16. 3%) were diagnosed with diabetes based on three weeks FBS levels evaluations. There were significant associations between BMI، HbA1c and taking nervous system agents and diabetes (P<0. 05)، but the differences between sex، family history، blood pressure، TG، LDL levels and occurrence of diabetes were not significant (P>0. 05).

Close monitoring of FBS levels before and within the first three weeks of the initiation of steroid therapy allows early detection of storied-induced diabetes in pemphigus patients. Moreover، evaluation of other risk factors associated with diabetes may provide the opportunity of early diagnosis and treatment of steroid-induced diabetes.