1361-P: Development and Validation of a Scoring System for Predicting the Need for Hypoglycemic Agents during Glucocorticoid Treatments

Introduction & Objective: Glucocorticoid (GC) treatments have widely contributed to induction and maintenance therapies. However, GC-induced hyperglycemia cannot be predicted by fasting plasma glucose and HbA1c alone. The aim of the study was to identify the risk factors for GC-induced hyperglycemia and have developed and validated a novel scoring system for predicting the need for hypoglycemic agents during GC treatment.

Methods: In a developing set, 508 adults receiving prednisolone (PSL) for the first time were divided into two groups based on their treatment with or without hypoglycemic agents. Their clinical and laboratory parameters were compared, and risk factors were identified using logistic regression analysis after performing univariate analyses between the two groups. A point-addition scoring system with several categories and their coefficients in each risk factor was constructed to predict the need for hypoglycemic agents. The scoring system was then applied and validated on two validation sets, A and B.

Results: Older age and higher HbA1c percentages, body mass index, and initial PSL dosage were identified as risk factors. The sensitivity, specificity, and accuracy of the scoring system were 70.6%, 81.9%, and 77.1% in the developing set, 75.8%, 78.4%, and 77.4% in the validation set A, 79.4%, 73.9%, and 75.3% in the validation set B, respectively.

Conclusion: The scoring system is a valid and reliable tool for predicting the need for hypoglycemic agents in advance during GC treatment.