Hyperglycemia due to the utilization of anabolic steroids

Abstract

Introduction. Hyperglycemia is a condition in which an excessive amount of glucose circulates in the blood plasma and is a common adverse reaction of anabolic steroids therapy, affecting 20% to 50% of patients without a history of diabetes. In addition, glucose levels are often elevated among patients with prediabetes and previously well-controlled diabetes during steroid therapy. Anabolics stimulate glucose production by the liver and inhibit peripheral glucose uptake, resulting in insulin resistance allowing blood glucose levels to rise and remain higher. Aim of the study. To determine the manifestations of hyperglycemia after utilization of anabolics. Materials and methods. It was made the bibliographic and personal investigations of hyperglycemic state due to anabolics. Twenty-five healthy male power athletes were followed up during their self-regimen of substance abuse. Results. In our investigation, there is determined that more than half of the men receiving highdose steroids develop hyperglycemia, with an incidence of 86% of at least one episode of hyperglycemia and 41% of athletes presenting a mean blood glucose ≥ 140 mg/dL Hyperglycemia incidence in men without a prior history of diabetes mellitus (DM) to steroid use varies from 34.3% to 56% for athletes with 1-3 years of anabolic utilization. The manifestations of hyperglycemia were: polyuria (36%), polydipsia (29%), polyphagia (41%), dizziness (18%), shakiness (19%), irritability or moodiness (37%), anxiety or nervousness (26%), trouble concentration (15%). The development of hyperglycemia was observed on 41% athletes, 29 - 41 years old, who reported a consumption of AAS for 1-3 years. They selfadministered high doses of oral stanozolol, oxymetholone, methandrostenolone and ibutamoren. For management of hyperglycemia, if diet and physical exercise do not reduce the glucose levels adequately, it is recommended to prescribe antidiabetic drugs, such as metformin, DPP-4 inhibitors or sulfonylureas that are effective and work by increasing insulin release from the pancreas but they may cause hypoglycemia. Conclusions. Complications associated with steroid-induced hyperglycemia are often underestimated despite hyperglycemia being a well-known adverse effect of anabolic therapy. Appropriate management of hyperglycemia due to anabolics is oral antidiabetic agent, such as a DPP-4 inhibitors, metformin, or by using the weight-based NPH insulin may reduce the risk of adverse outcomes, including symptomatic hyperglycemia and new-onset diabetes.