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Do you recommend using intermediate-acting insulin over long-acting insulin for the management of steroid-induced hyperglycemia?

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Which type of insulin do you prefer for managing steroid-induced hyperglycemia, especially in patients on once-daily prednisone?

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3 Answers
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Endocrinology · Michigan State University College of Human Medicine
Answered on

It depends on the dose of the steroids being used and whether the steroid use is for a short period or for prolonged chronic use. If the dose of the steroid is high and the use is intended for a short time, use of a short acting insulin may be preferred to combat the hyperglycemia, If the steroid us...

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Endocrinology · Kaiser Permanente Oakland Medical Center Endocrinology
Answered on

Yes, especially if the patient is on prednisone once a day. NPH given at the same time as prednisone works better than longer acting insulin.

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Endocrinology · Yale School of Medicine
Answered on

It depends on the clinical situation and on what type of steroids are being used, but intermediate-acting (e.g. NPH) insulin can be a reasonable approach for hospitalized patients on once-daily prednisone, for example. Monitoring is critical, and will guide further dose adjustments or a possible cha...

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