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These mechanisms occur within hours after GCs administration and may lead to hyperglycemia, even in individuals without a prior history of glucose abnormalities ( Figure 1 The clinical impact of hyperglycemia during GCs therapy has been well established, with multiple studies reporting increased morbidity and mortality, including higher rates of infection, cardiovascular events and prolonged hospitalisations ( Although glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are not currently recommended in SID by major guidelines, their mechanism of action makes them promising candidates to counteract the metabolic impacts of steroids

The biological hypothesis is plausible - collagen peptides supply the amino acids (glycine, proline, hydroxyproline) that bone matrix formation requires, which may be particularly useful when dietary protein is being restricted

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The key is consistent monitoring and guidance from medical professionals

To view a copy of this licence, visit About this article Cite this article Abid, M.S.R., Qiu, H., Tripp, B.A

2007;292:R1092R1100