Association Between Topical Corticosteroid Use and Type 2 Diabetes in Two European Population-Based Adult Cohorts

Diabetes Care 2019 Jun; 42(6): 1095-1103.

Topical corticosteroids (CSs) are commonly used to treat inflammatory skin conditions including eczema and psoriasis. Although topical CS package inserts describe hyperglycemia and glycosuria as adverse drug reactions, it is unclear whether topical CS use in real life is also associated with an increased risk of type 2 diabetes (T2D).

Two matched case-control studies and one cohort study were conducted using routinely collected health care data from Denmark and the U.K. A total of 115,218 and 54,944 adults were identified as case subjects with new-onset T2D in the Danish and U.K. case-control study, respectively. For the Danish cohort study, 2,689,473 adults were included. The main exposure was topical CSs, and the outcome was incident T2D.

Topical CS was significantly associated with T2D in the Danish (adjusted odds ratio [OR] 1.25 [95% CI 1.23–1.28]) and U.K. (adjusted OR 1.27 [95% CI 1.23–1.31]) case-control studies. Individuals who were exposed to topical CSs had significantly increased risk of incident T2D (adjusted hazard ratio 1.27 [95% CI 1.26–1.29]). We observed significant dose-response relationships between T2D and increasing potency of topical CSs in the two Danish studies. The results were consistent across all sensitivity analyses.

We found a positive association between topical CS prescribing and incident T2D in Danish and U.K. adult populations. Clinicians should be cognizant of possible diabetogenic effects of potent topical CSs.

Fazit ÄiW:

Lokale Steroide erhöhen das Risiko, an Diabetes zu erkranken. In der Regel brauchen es Chroniker, die darauf nicht verzichten können. Hier also aufmerksam bleiben.
Und nach Alternativen (Basistherapie) suchen, um die Häufigkeit der Exazerbationen zu vermindern.

Fazit Regen:

Unsere Patienten wissen oft gar nicht, dass sie Kortison in ihrer Salbe haben.
Es kommt nicht heraus, ob es sich um einen kortisoninduzierten Diabetes Typ 3 oder einen Typ 2 Diabetes handelt.