Palliative care and post-steroid hyperglycemia - case report

Renata Opalińska; Volodymyr Yasnitskyy; Anna Orońska

Vol 4, No 3 (2005): Polish Palliative Medicine

Case reports

Published online: 2005-09-09

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Palliative care and post-steroid hyperglycemia - case report

Renata Opalińska, Volodymyr Yasnitskyy, Anna Orońska

Advances in Palliative Medicine 2005;4(3):107-110.

Vol 4, No 3 (2005): Polish Palliative Medicine

Case reports

Published online: 2005-09-09

Abstract

The authors present the case of a 67-year-old patient with prostate cancer and brain metastases. A prolonged treatment with relatively high doses of steroids (dexamethason p.o. and s.c.) was necessary. Attempts to cease the treatment or lower the dose resulted in an impairment of consciousness and worsening of the quality of life of the patient. After 4 months of treatment with steroids, during a routine bi-weekly control of blood glucose, a hyperglycemia of 500 mg% was established. The patient was referred to the Department of Endocrinology and treatment with insulin was initiated. The patient returned home, where he was still taking steroids. His quality of life was good, and, he was fully conscious. In February 2004 he wrote a coherent and long letter about his existential feelings concerning the death.
The authors discuss the problem of using steroids in the patients with brain metastases and the treatment of diabetes in palliative care patients. They concluded, that palliative care does not exclude intensive treatment of correctable symptoms, if that allows to improve the quality of life as well as prolongs the life of the patient.