Deflazacort vs Prednisone

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Abstract
• Glucocorticoid treatment produces a deterioration of blood glucose control in diabetics. Recent reports have indicated that deflazacort is less diabetogenic than prednisone in healthy subjects. Ten insulin-treated diabetics who required steroid drugs were treated with deflazacort (30 mg/d for four weeks) and prednisone (25 mg/d for four weeks) in randomized, double-blind design after a pretreatment period of four weeks. At the end of each treatment, plasma glucose profile (five determinations per day), hemoglobin A1 level, and insulin requirements were compared. Mean (±SEM) plasma glucose level (139 ± 28 vs 169±32 mg/dL [7.7±1.5 vs 9.4 ± 1.8 mmol/L]) and hemoglobin A1 values (8.81%±1.19% vs 10.71%± 1.17% of total hemoglobin) were significantly lower after deflazacort than after prednisone. Also, insulin requirement was significantly lower after deflazacort than after prednisone (29.3 ± 11.6 vs 47.3 ± 2.0 U/d). These results indicate that deflazacort, when employed in an anti-inflammatory dose equivalent to prednisone, should prove advantageous in insulin-treated diabetics who require steroid treatment. (Arch Intern Med1987;147:679-680)