Glucocorticoid-induced hyperglycemia in ambulatory oncology: a systematic review of detection, monitoring, and management
Year: 2026
Type: study-registration
Abstract: This systematic review will examine the detection, monitoring, prevention, and management of glucocorticoid-induced hyperglycemia in adults with cancer receiving ambulatory care. Systemic glucocorticoids are widely used in oncology, but differences in treatment schedules, glucose surveillance, and outcome definitions complicate the interpretation of reported hyperglycemia frequencies and the comparison of care strategies. The review has two co-primary objectives: (1) to characterize the frequency of detected hyperglycemia, including the definitions, measurement methods, surveillance intensity, and observation windows used; and (2) to evaluate the process, glycemic-control, and safety outcomes of strategies addressing detection, monitoring, prevention, treatment, or implementation of care. A secondary objective will examine diagnostic accuracy when studies provide an appropriate index test, reference standard, and compatible assessment windows. Eligible populations will comprise adults with solid or hematologic malignancies, with or without pre-existing diabetes, exposed to oral or parenteral systemic glucocorticoids during outpatient, day-hospital, or home-based care. Indications may include antineoplastic treatment, premedication, antiemesis, cancer-related supportive care, transplantation-related complications, immune-related toxicities, and palliative care. Exclusively physiologic replacement and exclusively local glucocorticoid exposure will be excluded. Palliative care will not itself constitute an exclusion criterion; treatment intent and goals of care will be recorded, and findings from exclusively comfort-focused end-of-life care will be presented separately when they are not clinically comparable with other settings. The core bibliographic sources are PubMed, Scopus, CENTRAL, and LILACS, supplemented by trial registries, citation searching, and selected grey-literature sources. No publication-year or language restrictions will be applied. Two human reviewers will independently assess study eligibility and risk of bias, with disagreements resolved through discussion or third-reviewer adjudication. Data extraction will undergo complete verification by a second reviewer. Narrative synthesis will be the primary approach. Meta-analysis will be considered only when independent studies are sufficiently compatible in population, design, outcome definition, measurement, and follow-up. Frequency estimates, comparative intervention effects, and formal diagnostic-accuracy findings will be evaluated separately. Risk of bias and certainty of evidence will be assessed using approaches appropriate to each study design and review question. Expected outputs include a structured account of hyperglycemia ascertainment and frequency, an assessment of the benefits and harms of ambulatory care strategies, and identification of evidence gaps relevant to clinical practice and future research. The review will not assume that a pooled estimate is feasible or that any strategy is effective before the evidence has been assessed. Search development, pilot searches, technical validation, and consultation of selected full texts have occurred before registration. Formal screening calibration, definitive screening, and data extraction for synthesis have not begun. The approved protocol and subsequent amendments will provide a transparent record of the review methods.
Source: Open Science Framework
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7223202429