This study aimed to highlight the importance of routine screening for hyperglycemia and to develop a standardized, evidence-based approach for the management of pemphigus patients on prolonged systemic corticosteroid (CS) therapy. A cross-sectional study was conducted in two university-affiliated teaching hospitals using a referred sample of 200 patients with a confirmed diagnosis of pemphigus vulgaris, pemphigus foliaceus, or mucous membrane pemphigoid. All patients were receiving systemic CS therapy. A total of 150 patients responded to the survey. Six participants were excluded and 144 were included. The main outcome measure was blood glucose level to detect hyperglycemia. New-onset hyperglycemia was identified in 40% of patients who received CS therapy. None of the expected variables, including age, body mass index, family history of diabetes, corticosteroid dose, and duration of corticosteroid therapy, were independently associated with new-onset hyperglycemia. These findings indicate that the prevalence of CS-induced hyperglycemia in pemphigus patients is 40% and that in patients with pemphigus or MMP, CS therapy is associated with a markedly increased risk for hyperglycemia (odds ratio = 10.7, 95% confidence interval 1.38-83.50) compared with that of patients with the same diseases who do not receive CS therapy.

译文

:这项研究的目的是强调常规筛查高血糖的重要性,并开发一种标准化的,循证的方法来治疗天疱疮患者,以延长的全身性皮质类固醇(CS)治疗。在两所大学附属教学医院中进行了一项横断面研究,使用了200名患者的参考样本,这些患者被确诊为寻常型天疱疮,叶天疱疮或粘膜天疱疮。所有患者均接受全身CS治疗。共有150位患者对此调查做出了回应。六名参与者被排除在外,其中包括144名。主要结果指标是检测高血糖的血糖水平。在接受CS治疗的患者中,有40%发现了新发的高血糖症。新出现的高血糖症与年龄,体重指数,糖尿病家族史,糖皮质激素剂量和糖皮质激素治疗持续时间等预期变量均无关。这些发现表明,天疱疮患者中CS引起的高血糖的患病率为40%,天疱疮或MMP患者中,CS治疗与高血糖的风险显着相关(优势比= 10.7,95%置信区间1.38-83.50 )与没有接受CS治疗的相同疾病的患者相比。

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