Glucocorticoids can be divided into 4 dose ranges.
Low dose: prednisone ≤ 7.5mg/d (methylprednisolone ≤ 6mg/d).
Medium dose: prednisone 7.5-3mg/d (methylprednisolone 6-24mg/d)
High dose: prednisone 30-100 mg/d (methylprednisolone >24-80 mg/d)
Shock therapy: methylprednisolone 500-1000 mg/d intravenously.
Steroidal diabetes mellitus rarely occurs when small or moderate doses of glucocorticoids are used for 3 months, but >3 months, or even more than 1 year, some patients develop hyperglycaemia or diabetes mellitus.
About 10% to 30% of patients on high doses of glucocorticoids for 3 months will develop reduced glucose tolerance or diabetes mellitus.
The duration of glucocorticoid shock therapy is usually 7-10 days. If oral glucocorticoids are not followed up, diabetes rarely occurs in people of young age and without risk factors for diabetes, but the chances of hyperglycaemia and diabetes increase significantly in those who continue with subsequent oral medication, especially those on repeated shock therapy + oral medication for a long period of time.
With high doses of glucocorticosteroids, blood glucose can rise within a short period of time, or the pre-existing hyperglycaemic state can worsen.
In conclusion, whether glucocorticoid therapy causes steroidal diabetes is related to the age of the patient, the presence of risk factors for the development of diabetes (family history of diabetes, obesity, history of gestational diabetes and age > 40 years), the dose of the hormone and the duration of its use.