Following the launch of the guidance for the management of long term high dose steroid therapy – ‘Steroid Safety Bundle’ in June 2023, there has been some amendments. The most recent version of this guidance can be found here – Steroid Safety Bundle: Management of long term high dose steroid therapy . The amendments are detailed below:
Amendment 1
The highlighted paragraph on page 2 (Figure 1), under the title ‘Steroid ‘Sick Day Rules’ & Safe Steroid Withdrawal’ has been amended “Sick day rule dosing for patients at risk of adrenal crisis” (Figure 2).
Figure 1
![](https://services.nhslothian.scot/diabetesservice/wp-content/uploads/sites/50/2023/10/image-7.png)
Figure 2
![](https://services.nhslothian.scot/diabetesservice/wp-content/uploads/sites/50/2024/01/Steroid-Safety-Bundle-Update-2.jpg)
Amendment 2
The ‘Recommendations For Screening & Monitoring For Steroid-induced Diabetes’ flowchart on page 2 has been replaced with an updated version.