Esteroides topicos y DMT2

Plain Language Summary

Are corticosteroid creams and ointments linked with type 2 diabetes?

First published: 01 July 2020

https://doi.org/10.1111/bjd.19182

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Abstract

Cosrtiocosteroids, such as prednisone and dexamethasone, are a common treatment for many skin issues. People who take these medicines by mouth are at greater risk of developing type 2 diabetes. It is not clear whether absorption of corticosteroid from creams or ointments also carries this risk. A recent study found a potential risk of using corticosteroid creams and developing type 2 diabetes.

The authors aimed to appraise this recent publication; the study from Denmark and the UK (Andersen et al Diabetes Care 2019;42:1095‐1103), explored whether topical (applied to the skin) use of corticosteroids was linked with the new development of type 2 diabetes. The researchers used health data from the Danish national registry in two studies and the UK clinical practice research database in a further study. These data are routinely collected and used often for research. They found a higher prevalence of type 2 diabetes in patients receiving topical corticosteroids in all three studies. In the two Danish studies, the use of higher potency corticosteroids was linked to a higher risk of diabetes.

The reviewers felt that the strengths of the studies were that the researchers used high quality databases that are commonly used for research, had access to a large number of patients' data, and that they allowed for major confounding factors, which are variables that may affect the results. Importantly, some study patients were also using systemic (oral pills and capsules) or inhaled corticosteroids. Itch is a common, and often non‐specific, symptom, and patients may be prescribed topical corticosteroids for a variety of conditions which are also associated with diabetes; furthermore common skin diseases such as eczema and psoriasis are linked to a higher risk of diabetes.

They stress that an association does not necessarily prove cause and effect. Despite these caveats, the reviewers advise to continue using topical corticosteroids sparingly, always weighing up benefits versus risk. They recommend screening for type 2 diabetes in patients receiving treatments for chronic diseases.