Glucocorticoids remain widely used for their anti-inflammatory and immunosuppressive effects, but concerns about diabetes risk persist. This study, presented at EASD 2025, evaluated the metabolic impact of systemic, inhaled, and topical glucocorticoid exposure in a large, registry-based case-control setting.
Data from the Danish National Patient Registry (2013–2021) included 124,508 adults diagnosed with type 2 diabetes and 356,117 matched controls. Glucocorticoid prescriptions within the year before diagnosis were categorized as systemic, inhaled, or topical. Conditional logistic regression assessed odds of T2DM for each exposure, with dose-response patterns analyzed by the number of redeemed prescriptions.
Systemic glucocorticoids demonstrated the strongest association with diabetes, driven by prednisolone (OR 1.70) and hydrocortisone (OR 1.55). Topical glucocorticoids also increased diabetes risk across potency groups (ORs 1.09–1.16), with higher prescription counts linked to higher odds. Inhaled glucocorticoids showed no significant association (OR 0.96).
These results underscore the need for cautious systemic and topical glucocorticoid use and suggest dose intensity plays a key role in diabetes risk, while inhaled formulations appear metabolically neutral.
