OBJECTIVE: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease and corticosteroid (CS) is the mainstay of treatment in SLE. As a result, SLE patients are susceptible to the undesirable metabolic side-effects of longterm CS use, such as insulin resistance which may lead to hyperglicemia. The aim of our study is to determine the pattern of blood glucose levels in SLE pediatrics patients at dr. Kariadi Hospital, Semarang.
METHOD: A descriptive study of 56 children with a diagnosis of SLE based on the criteria of the American College of Rheumatology (ACR) revision during 2017-2018. The diagnosis of diabetes mellitus is based on the 2010 American Diabetes Association’s criteria: fasting plasma glucose ? 126 mg/dL (7.0 mmol/L) or HbA1c ? 6.5 or 2-h plasma glucose ? 200mg/dL (11.1 mmol/L) during an oral glucose tolerance test (OGTT). Laboratory examination of SLE patients are collected several times, to evaluate blood glucose levels in pediatrics patients with SLE.
RESULT: Fifty-six patients, consisting of 52 girls and four boys. Seven (12,5%) of them have elevated blood glucose levels, with the mean age is 14.6 years. All patients receives methylprednisolone (MP) according to protocol therapy of SLE at dr. Kariadi Hospital Semarang and seven patients develops elevated blood glucose levels, within first 2 weeks until 6 months during MP therapy (Mean 3,6 months) with various clinical manifestations of SLE. From seven patients who developed hyperglycemia, only two patients complained of polidipsi, polifagi, polyuria and five other did not complain about any symptoms of hyperglycemia.
CONCLUSION: Elevated glucose level are found as early as first 2 weeks of therapy. Early evaluation and control of blood glucose levels should be done, in patients with SLE who are on long-term MP treatment, even symptomatic or asymptomatic.