Utilization of Indian diabetes risk score (IDRS) in steroid-induced diabetes

Introduction Steroid-induced diabetes (SID) can be defined as the occurrence of hyperglycemic state in non-diabetic individuals following steroid therapy. The traditional risk factors for type 2 DM, such as age, abdominal obesity, family history, and physical activity, have been incorporated in the Indian diabetes risk score (IDRS). We conducted this study to determine the use of IDRS in the prediction of SID. Materials and methods A prospective observational, cohort study on non-diabetic subjects, aged between 18 and 70 years, on oral or parenteral steroid therapy for different diseases was conducted. Anthropometric records were collected. Baseline biochemical parameters in the blood (FPG, PPG, and HbA1c) were measured before initiating steroid therapy. The biochemical parameters, except HbA1c, were measured again on day 3 after steroid therapy initiation. Based on FPG and PPG of day 3, participants were categorized as normal, pre-diabetic, and diabetic. Based on IDRS, patients with SID were categorized as low-risk, moderate-risk, and high-risk IDRS groups for further analysis. Results Out of 317 subjects, SID was found in 132(42%) subjects. We observed significantly higher age (p value = 0.04) and BMI (p value = 0.03) in diabetes group compared to normal and pre-diabetes groups. There was no significant difference (p = 0.6) in mean waist circumference across steroid-induced diabetic groups. A sedentary lifestyle (p = 0.359) and family history (p value = 0.388) have no association with SID. The incidence of SID was significantly high among high-risk IDRS (58%) when compared to that of low-risk (34.8%) and medium-risk (36%) IDRS (p < 0.001). IDRS more than 60 showed odds ratio of 1.69 (95% C.I, 1.24-2.16, p < 0.001) for steroid-induced diabetes. IDRS of more than 30 had 71.4% sensitivity and 44.6% specificity for SID (p value = 0.001). Conclusions The cumulative scores of IDRS were higher in patients with SID. This score may be used as an initial screening test to select patients for blood sugar monitoring in those treated with steroids on OPD basis.