Сarbohydrate metabolism disorders in rheumatology patients receiving glucocorticoid therapy (literature review)
G.I. NURULLINA1, N.G. SHAMSUTDINOVA1, R.Z. ABDRAKIPOV2, Е.V. SUKHORUKOVA2, N.A. BOLSHAKOV1, G.Sh. SABIROVA1, A.K. KHUSAINOVA1
1Kazan State Medical University, Kazan
2Republican Clinical Hospital of the MH of RT, Kazan
Contact:
Nurullina G.I. ― PhD (medicine), Assistant of the Department of Hospital Therapy
Address: 49 Butlerov Str., Kazan, Russian Federation, 420012, tel. +7-987-290-18-20, e-mail: nurguzel@yandex.ru
The article reviews the physiology of adrenal cortex hormones, their influence on the state of carbohydrate metabolism. Particular attention is paid to the mechanisms of formation of carbohydrate metabolism disorders in patients receiving glucocorticoids (GC). Two main modes of systemic therapy with glucocorticoids in rheumatology patients are described: pulse therapy and oral therapy. The literature data is analyzed on the impact of different modes of GC therapy on carbohydrate metabolism and the risk of diabetes. It is noted that GC pulse therapy, despite ultra-high doses of glucocorticoids, is safer than long-term oral GC therapy for both adverse phenomena and suppression of the hypothalamic-pituitary-adrenal system. Recommendations for the management of patients with impaired carbohydrate metabolism on glucocorticoid therapy are given.
Key words: diabetes mellitus, glucocorticoids, systemic glucocorticoid therapy, pulse-therapy.
(For citation: Nurullina G.I., Shamsutdinova N.G., Abdrakipov R.Z., Sukhorukova Е.V., Bolshakov N.A., Sabirova G.Sh., Khusainova A.K. Сarbohydrate metabolism disorders in rheumatology patients receiving glucocorticoid therapy (literature review). Practical medicine. 2019. . Vol. 17, № 6 (part 1), P. 15-19)
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