PLASMA GLUCOSE, INSULIN AND FREE FATTY ACIDS DURING LONG-TERM CORTICOSTEROID TREATMENT IN CHILDREN

ABSTRACT The effect of long-term corticosteroid treatment on glucose-insulin-free fatty acid interrelationships was studied in 25 children. The fasting blood glucose level and glucose tolerance after oral glucose administration were normal in all cases. The mean plasma insulin concentration on the other hand was significantly higher during the glucose tolerance tests. Free fatty acid levels were moderately lower in the fasting plasma and significantly lower 30 min after glucose administration. This shift in the balance between the changes studied may contribute to the fat deposition often seen during corticosteroid treatment. There was no correlation between the actual dose of the drug and the insulin levels. Children – even if treated with corticosteroids for years – are able to maintain a normal glucose tolerance as a result of a continuous elevated insulin level. Arginine stimulation also resulted in a trend to higher insulin levels in the corticosteroid treated group but the difference from the normal was much smaller than after glucose administration.