International Journal For Multidisciplinary Research

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Prevalence and Clinical Profile of Corticosteroid-Induced Hyperglycaemia and Immunosuppression in Hospitalised Adults: A Multi Arm Retrospective Cross-Sectional Study from Tertiary Care Hospitals

Author(s) Dr. Nuwalid Nissar Lala, Dhupiga Jeykumar Shanthi, Dr. Anurag Jain, Chaudhari Saumya
Country India
Abstract Background: Corticosteroids are widely used in hospitalised adults for inflammatory, autoimmune, respiratory, neurological, and infectious conditions. While their short-term benefits are well recognised, systemic corticosteroids are associated with significant metabolic and immunological adverse effects, notably hyperglycaemia and immunosuppression. These complications gained particular prominence during the COVID-19 pandemic, when widespread steroid use, combined with oxygen therapy and pre-existing diabetes, was linked to a surge in opportunistic infections such as mucormycosis and invasive aspergillosis. Data from Indian tertiary care settings evaluating the combined burden of corticosteroid-induced hyperglycaemia and immunosuppression remain limited.

Objectives: To determine the prevalence of corticosteroid-induced hyperglycaemia and immunosuppression among hospitalised adults, describe their clinical profile, identify associated complications including infections and electrolyte disturbances, and evaluate outcomes in a tertiary care hospital setting.

Methods: This multi-arm retrospective cross-sectional study was conducted in tertiary care hospitals over a 12-month period. Medical records of 164 hospitalised adults (≥18 years) who received systemic corticosteroids for ≥5 days were analysed. Patients were stratified into three arms: (1) known diabetics, (2) newly detected hyperglycaemia following steroid initiation, and (3) normoglycaemic patients. Data collected included demographic variables, indication, type and dose of corticosteroids, glycaemic parameters, markers of immunosuppression, infectious complications, electrolyte abnormalities, neuromuscular, neuropsychiatric, and cardiovascular effects. Outcomes were analysed using descriptive statistics.

Results: Out of 164 patients, corticosteroid-induced hyperglycaemia was observed in 98 patients (59.8%). Newly detected hyperglycaemia occurred in 46 patients (28.0%), while worsening glycaemic control in known diabetics was seen in 52 patients (31.7%). Immunosuppression-related infections were documented in 41 patients (25.0%), with mucormycosis identified in 9 patients (5.5%) and invasive aspergillosis in 7 patients (4.3%), predominantly among diabetics and post-COVID patients receiving oxygen therapy. Febrile neutropenia was noted in 6 patients (3.7%). Additional adverse effects included hypernatremia (18.9%), proximal neuromuscular weakness (14.6%), neuropsychiatric manifestations (11.0%), and cardiovascular complications such as hypertension and arrhythmias (16.5%). Mortality was higher among patients with combined hyperglycaemia and severe infections.

Conclusion: Corticosteroid-induced hyperglycaemia and immunosuppression are common and clinically significant among hospitalised adults, particularly in patients with diabetes and those treated during the COVID-19 pandemic. Vigilant monitoring, early identification of metabolic and infectious complications, and judicious tapering of steroids are essential to prevent adverse outcomes, including life-threatening opportunistic infections and adrenal insufficiency.
Keywords Corticosteroids, Hyperglycaemia, Immunosuppression, Diabetes Mellitus, Mucormycosis, Invasive Aspergillosis, COVID-19, Hospitalised Adults
Field Medical / Pharmacy
Published In Volume 8, Issue 1, January-February 2026
Published On 2026-01-19
DOI https://doi.org/10.36948/ijfmr.2026.v08i01.66923
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