Abstract Details

Title Steroid Exposure & Hyperglycemia in Multiple Sclerosis (MS) and Headache (HA) Patients: A Retrospective Chart Review

Topic MS and Related Diseases

Presentation(s) P01 - (-)

Poster/Presentation
Number 198

Objective

Background BACKGROUND: Commonly MS patients recieve IV steroid treatments for acute relapse without glycemic monitoring. MS patients have several risk factors for insulin resistance, including reduced mobility, sedentary lifestyle, and exposure to steroids. Cardiovascular co-morbidities including diabetes have been associated with MS disease progression and reduced quality-of-life.

Design/Methods DESIGN/METHODS: We preformed an administrative database search for individuals with a diagnosis of MS or HA who were admitted to the neurology inpatient service. We then completed a retrospective chart review to identify patients who also received IV steroid treatment, had serum blood glucose levels available, and meet eligibility criteria. Exclusion criteria included diabetes diagnosis or use of glucose-modifying medications.

Results RESULTS: Fifty patients (29 MS & 21 HA) were admitted, recieved IV steroids for MS relapse or HA management, were non-diabetic and had pre and post-steroid blood glucose (BG) levels available. The two groups were well matched for age, sex, weight, and pre-steroid BG levels (p-value > 0.05). Post-steroid BG level was significantly higher in the MS compared to HA patients (mean 177 ± 53, range 125 - 259 vs mean 142 ± 27, range 88 - 171; p-value = 0.0037) and the proportion of patients with BG > 126 across first 2 days post-steroids was significantly greater in MS patients (69% vs 29%, p = 0.0048). Finally, in a multiple regression model, diagnosis (MS vs. HA) was a the only significant predictor of post-steroids blood glucose levels.

Conclusions CONCLUSIONS: Increased hyperglycemia in MS compared to HA patients following a steroid challange has not been previously reported and the mechanism remains uncertain. Future prospective studies are needed to understand the potential hyperglycemic mechanisms including insulin resistance, and assess the impact hyperglycemia has on MS-related neuroinflammation and neurologic recovery.

Authors/Disclosures
Myla D. Goldman, MD, MSc, FAAN (Virginia Commonwealth University) PRESENTER	Dr. Goldman has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Genentec. Dr. Goldman has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Immunic. Dr. Goldman has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novartis Pharmceuticals. Dr. Goldman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Kiniska. Dr. Goldman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for TG Therapeutics. Dr. Goldman has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Brainstorm Cell Therapeutics Ltd., . Dr. Goldman has received personal compensation in the range of $500-$4,999 for serving as a Study Section Member with NIH. Dr. Goldman has received personal compensation in the range of $0-$499 for serving as a Grant Review Committee Member with Department of Defense.
	No disclosure on file
	No disclosure on file
Stuart D. Cook, MD, FAAN (Rutgers)	No disclosure on file

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