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Saturday 12, Sep 2009

  Steroids may have greater impact on diabetics

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Steroids may have greater impact on diabeticsIf you are a diabetic and there is a need for you to undergo steroid therapy, your doctor should advise you on adjusting your diabetes therapy.

Steroids, particularly glucocorticoids can affect the glucose level in a person’s bloodstream. Glucocorticoids include hydrocortisone, prednisone, prednisolone, dexamethasone and betamethasone.

Since insulin is the only hormone that could overcome this effect, increase in insulin doses may be needed. The diabetic may also need to plan his meals or control his food intake since steroid can increase hunger.

Steroids can also make a non-diabetic increase their blood sugar levels. Steroids can make the liver produce sugar from substances such as proteins and fats. Steroids can also inhibit insulin release from the pancreas and its action in our body tissues.

The type of steroids and the form of administration can have various effects on sugar levels. Generally, inhaled and topical steroids have less effect on blood sugar levels compared to other types and routes of delivery.

Dosages also affect sugar levels. If steroids are given in low doses, it may have no effect on sugar levels, while moderate to higher doses can increase sugar levels significantly.

Fortunately, this effect is reversible. Once steroid therapy is stopped, blood sugar levels usually returns to normal.

Tuesday 18, Aug 2009

  Repeated steroids on preemies can increase incidence of cerebral palsy

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Repeated steroids on preemies can increase incidence of  cerebral palsyAlthough the corticosteroid betamethasone can improve the survival rate of premature babies, it may also increase their risk for developing cerebral palsy. Betamethasone is used to accelerate lung development in premature babies. It may also decrease the incidence and mortality from intracranial bleeding in premature babies.

According to results of studies funded by the National Institutes of Health headed by Ronald Wapner, MD, an obstetrics and gynecology professor at the Columbia University Medical Center and an attending obstetrician and gynecologist at the New York Presbyterian Hospital in Columbia, repeated courses of steroids lack safety evidence.

To study the long-term effects of steroids, women who continued pregnancy a week after the initial steroids treatment were given a weekly course of steroids or placebo until the babies were born.

The incidence of cerebral palsy among children whose mothers received long-term steroids treatment were found to be higher compared to those whose mothers only received placebo.

By ages two to three years old, those children with physical or neurological defects were diagnosed to have cerebral palsy.

Since long-term benefits of corticosteroids were not established among pregnant women, Dr. Wapner concluded that doctors should take precaution in administering weekly courses due to the potential harm it may cause to the child.

According to Eurekalert:

NEW YORK – Repeated courses of a drug that is used to improve the survival of unborn premature babies also may increase the risk of cerebral palsy in those children, according to results from a multi-center study, funded by the National Institutes of Health and led by Ronald Wapner, M.D., professor of obstetrics and gynecology, Columbia University Medical Center and attending obstetrician and gynecologist at NewYork-Presbyterian Hospital/Columbia.

Wednesday 08, Jul 2009

  Repeated Courses Of Steroids – Safe On Preterm Babies

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Repeated Courses Of Steroids – Safe On Preterm BabiesA study finds that repeated courses of steroids to women in preterm labor do not result in brain damage of the baby in the womb as believed and that the treatment enhances the survival rate of the babies.

Previous studies showed neurological complications from multiple courses of dexamethasone, a steroid prepared with sulfur. However, clinicians do not use that steroid anymore and have switched to sulfur-free steroids, such as betamethasone. The study was based on infants who received betamethasone prior to birth, and they did not show the same adverse effects as previous studies.

Researchers said that there were no significant differences in the brain’s responses to the testing between the 50 babies who received one course of steroids and the 29 who received multiple courses, even when controlled for gestational age, birth weight, race and exposure to illegal drugs. There were also no significant differences between the 51 infants who received no steroids and those who did. The only medical difference between those infants who received one course and those who received more was that the ones who received more were less likely to need mechanical ventilation the day they were born.

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