Glucose Effects of Oral Budesonide Compared with Systemic Corticosteroids
Adverse‑event profile of budesonide in inflammatory‑bowel‑disease trials
- In randomized controlled trials of oral budesonide (≈6–9 mg/day) for ulcerative colitis and Crohn’s disease, the drug showed a significantly lower overall adverse‑event rate (relative risk 0.64; 95 % CI 0.54–0.76) and reduced adrenal‑axis suppression versus conventional systemic corticosteroids; no clinically significant hyperglycemia was reported as a common adverse effect. (Evidence from high‑quality RCTs) [1][2]3
Hyperglycemia associated with high‑dose prednisone
- In patients receiving prednisone 40–60 mg/day, afternoon and evening blood‑glucose elevations occur in the majority of individuals, frequently requiring multiple‑dose insulin regimens (≈1–1.2 U/kg/day, with 25 % basal and 75 % prandial components) to achieve glycemic control. (Observational data) 4
Incidence of steroid‑induced hyperglycemia and relevance to budesonide
- Glucocorticoid‑induced hyperglycemia occurs in 15 %–70 % of patients treated with systemic steroids, whereas this risk does not apply to standard‑dose oral budesonide because of its minimal systemic exposure. (Systematic review) 5