How can I find clinical trials on steroid-induced hyperglycemia?

Finding Clinical Trials on Steroid-Induced Hyperglycemia

To find clinical trials on steroid-induced hyperglycemia, use ClinicalTrials.gov and search for "steroid-induced hyperglycemia" or "glucocorticoid hyperglycemia" as these are the most specific search terms that will yield relevant results.

Understanding Steroid-Induced Hyperglycemia

Steroid-induced hyperglycemia is a common complication affecting 10-60% of patients receiving glucocorticoid therapy 1. This condition significantly increases mortality and morbidity risk through infections and cardiovascular events.

Key characteristics:

• Occurs in both patients with and without pre-existing diabetes
• Develops rapidly, often within 48 hours of starting steroid therapy 2
• When prednisone is administered as a morning dose, glucose levels typically peak in the afternoon 2
• The highest glucose concentrations are typically detected on the 3rd day of steroid therapy, 2 hours after meals 3

Specific Search Strategy for Clinical Trials

1. Primary resource: ClinicalTrials.gov

   • Use the advanced search function
   • Enter search terms: "steroid-induced hyperglycemia" OR "glucocorticoid hyperglycemia" OR "steroid diabetes"
   • Filter by "Recruiting" status if you want active trials

2. Additional databases to search:

   • WHO International Clinical Trials Registry Platform (ICTRP)
   • EU Clinical Trials Register
   • ISRCTN registry
   • PubMed Clinical Queries (filter for "Clinical Trial")

3. Search term combinations to try:

   • "dexamethasone AND hyperglycemia"
   • "prednisone AND diabetes"
   • "glucocorticoid AND insulin resistance"
   • "steroid AND glucose monitoring"

Key Topics in Current Research

When searching for trials, focus on these important areas of investigation:

1. Monitoring protocols

   • Trials evaluating blood glucose monitoring every 2-4 hours during initial steroid therapy 1
   • Studies on continuous glucose monitoring during steroid therapy

2. Insulin management approaches

   • Trials comparing NPH insulin (0.1-0.2 units/kg/day) with other insulin regimens 1
   • Studies on prandial insulin adjustments (40-60% increases for higher glucocorticoid doses) 1

3. Dose-response relationships

   • Research on the relationship between steroid dose and hyperglycemia severity 4
   • Studies examining the timing of hyperglycemia in relation to steroid administration 3

4. Prevention strategies

   • Trials testing preventive measures for high-risk patients
   • Studies on oral agents for postprandial hyperglycemia management

Practical Tips for Finding Relevant Trials

1. Filter by population characteristics:

   • Non-diabetic patients receiving steroids
   • Diabetic patients requiring steroid therapy
   • Specific conditions requiring steroids (e.g., COPD, rheumatic diseases)

2. Look for specific outcome measures:

   • Blood glucose control
   • Insulin requirements
   • Hyperglycemia prevention
   • Quality of life impacts

3. Consider intervention types:

   • Insulin protocols
   • Oral antidiabetic agents
   • Monitoring technologies
   • Educational interventions

4. Contact research centers:

   • Major academic medical centers often have endocrinology departments conducting relevant research
   • Diabetes research centers may have unpublished or upcoming trials

Common Pitfalls When Searching for These Trials

1. Terminology variation: Some trials may use "glucocorticoid-induced diabetes" rather than "hyperglycemia"

2. Hidden within broader studies: Steroid-induced hyperglycemia may be a secondary outcome in trials focused on the primary condition requiring steroid treatment

3. Overlooking relevant populations: Trials in specific populations (e.g., transplant recipients, oncology patients) may have valuable data but not appear in general searches

4. Missing observational studies: While not interventional trials, observational studies may provide valuable insights into management approaches

By following this structured approach, you can effectively identify relevant clinical trials investigating steroid-induced hyperglycemia and stay informed about the latest research in this important clinical area.