Drug-induced hyperglycemia is an elevation in the serum glucose that is due to a side effect from a medication. Prolonged hyperglycemia can lead to impairment in glucose tolerance and subsequent development of diabetes mellitus, analogous to diabetes that can result from obesity and metabolic syndrome. Sustained serum glucose > 126 mg/dL is diagnostic of hyperglycemia.

Most patients with hyperglycemia are asymptomatic. If sustained, patients will note the development of increased urinary frequency. Hyperglycemia will be detected on serologic testing. If the offending medication is prescribed for short-term use, the likelihood of developing underlying glucose tolerance impairment is low. If the medication is for chronic use, patients are at heightened risk for the development of glucose intolerance and the downstream manifestations of diabetes mellitus type 2.

Patients may present with diabetic ketoacidosis (DKA), a state of severe dehydration and acidemia due to insulin deficiency.

Common medications that can cause hyperglycemia include:

• Glucocorticoids
• Oral contraceptives
• Beta blockers
• Thiazide diuretics
• Nicotinic acid
• Statins
• Protease inhibitors
• Gonadotropin-releasing hormone agonists
• Tacrolimus
• Sirolimus
• Cyclosporine
• Olanzapine
• Clozapine
• Immune checkpoint inhibitors

Related topic: hyperglycemia