Short courses of oral corticosteroids, often perceived as low-risk, were tied to serious adverse events in people with type 2 diabetes, according to an analysis published in JAMA Network Open. The self-controlled case series drew on data from 36,048 patients in Taiwan's National Health Insurance Research Database from 2008 to 2022.
Within 30 days of starting a steroid burst (continuous use for 14 days or less), risks were elevated for pneumonia (incidence rate ratio 2.06), heart failure (1.87), and gastrointestinal bleeding (1.71). Signals also appeared for sepsis and fracture. Elevated risks for fracture and GI bleeding persisted into days 31 to 90.
The authors, led by Tsung-Chieh Yao of Chang Gung Memorial Hospital, noted that patients with type 2 diabetes already have higher baseline risks for infection, cardiovascular events, and fracture. They called for judicious prescribing, particularly for self-limited conditions where alternatives are available. Limitations included the inability to verify medication adherence, a lack of lifestyle data, and potential limits to generalizing the findings beyond Asian populations.