JAMA Netw Open

Short-course steroids in children tied to risk for hyperglycemia, sleep disturbance

October 2, 2025

While short-course corticosteroids appear generally safe, clinicians should monitor for sleep and glucose-related effects. An individualized approach is recommended, especially in patients with underlying risk factors.

Study details: This systematic review and meta-analysis evaluated adverse events (AEs) associated with short-term (≤14 days) systemic corticosteroid use in children and adolescents (ages 1–18). Researchers analyzed 45 randomized trials involving 6,470 pediatric patients across various acute conditions. Outcomes included serious AEs, treatment discontinuation, behavioral changes, hyperglycemia, sleep disturbances, and GI bleeding.

Results: Moderate-certainty evidence showed no significant increase in serious AEs, discontinuation, or behavioral changes. However, corticosteroids were associated with increased risks of hyperglycemia (risk difference [RD], 38 more per 1,000), sleep disturbances (RD, 15 more per 1,000), and GI bleeding (RD, 13 more per 1,000), though the latter had low certainty. Most AEs weren't serious.

Source:

Lima JP, et al. (2025, September 2). JAMA Netw Open. Adverse Events Following Short-Course Systemic Corticosteroids Among Children and Adolescents: A Systematic Review and Meta-Analysis. https://pubmed.ncbi.nlm.nih.gov/41026484/