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Oral Steroids May Raise Risks for Diabetes, HTN, VTE in Children

But absolute risks for these complications still low among children receiving glucocorticoids

WEDNESDAY, Sept. 23, 2020 (HealthDay News) -- Children with current glucocorticoid exposure have increased risks for diabetes mellitus, hypertension, and venous thromboembolism (VTE), according to a study published online Sept. 9 in the American Journal of Epidemiology.

Daniel B. Horton, M.D., from the Rutgers Robert Wood Johnson Medical School in New Brunswick, New Jersey, and colleagues conducted a retrospective study of more than 930,000 children diagnosed with autoimmune diseases or a nonimmune comparator condition identified using U.S. Medicaid claims from 2000 to 2010. The associations between glucocorticoid dose per age-/sex-imputed weight and incident-treated diabetes, hypertension, and VTE were estimated.

The researchers found the lowest crude rates for VTE (unexposed: 0.5/million person-days; currently exposed: 15.6/million person-days) and the highest for hypertension (unexposed: 6.7/million person-days; currently exposed: 74.4/million person-days). For all outcomes, the absolute rates were higher in unexposed and exposed children with autoimmune diseases compared with those with attention-deficit/hyperactivity disorder. Current glucocorticoid exposure had a strong dose-dependent relationship with all outcomes (adjusted hazard ratios for high-dose glucocorticoids: 5.93, 19.13, and 16.16 for diabetes mellitus, hypertension, and VTE, respectively).

"While children receiving high-dose steroids were at substantially higher risk for developing diabetes, high blood pressure or blood clots relative to children not taking these medicines, the absolute risks of these complications were still small," Horton said in a statement. "The vast majority of children taking brief courses of steroids for conditions such as asthma, for instance, will not experience these complications."

Several authors disclosed financial ties to the biopharmaceutical industry.

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