Diabetes and Steroid Use

Diabetes and Steroid Use

Steroid-Induced Diabetes and How Steroids Impact Blood Sugar Control

For the more than 37 million Americans living with diabetes, it’s no secret that what we put into our bodies can have a major impact on blood sugar levels - the foods we eat, how much alcohol we drink, sneaking those sweet treats once and a while, and the medications we take all can have an impact on our blood glucose levels.

Steroids are one of the common medications known to elevate blood sugar. In fact, they can have such a dramatic impact taking steroids can lead to what is called steroid-induced diabetes. 

In this post, we’ll look at steroids and how they can lead to the development of steroid-induced diabetes, as well as how being prescribed steroids can impact those already living with diabetes and how they manage their individual conditions.

What are steroids?

The term “steroids” is short for corticosteroids, which are artificial versions of hormones that are naturally produced in the body. Steroids reduce inflammation and are prescribed to treat a lot of medical conditions, including asthma, cystic fibrosis, arthritis, inflammatory bowel disease, and even some types of cancer. There are numerous different types of steroids that can be prescribed, including prednisone, hydrocortisone, and dexamethasone. There are also inhaled forms often used for asthma and other respiratory conditions like COPD. These include beclomethasone, budesonide, and fluticasone.

Unfortunately, the term “steroids” has also been used to describe anabolic steroids, which are sometimes used without medical advice to increase muscle mass. These are not the steroids we’re referring to in this post.

Steroid-induced diabetes

Steroid-induced diabetes is a dramatic increase in blood sugars directly related to the administration of steroids. It can happen to anyone, whether that person has a family history of diabetes or not. Steroid-induced diabetes more closely resembles Type 2 diabetes than Type 1 diabetes. While the pancreas is still able to produce insulin, the body’s cells are unable to respond properly to it leading to a rise in blood sugar. Steroids can increase blood sugar in compounded ways: 

  1. Steroids often cause the liver to release more blood sugar, which naturally elevates levels.
  1. Add the fact that steroids can also reduce the body’s sensitivity to insulin and now you have an increase in blood sugar along with a decrease in the body’s ability to process it. 

Ultimately, too much glucose remains in the blood and the result is steroid-induced diabetes.

Treating steroid-induced diabetes

The good news is that in most cases, when steroid use is prescribed by a physician for a specific period to treat a specific condition, steroid-induced diabetes will go away shortly after the cycle of steroid use has ended. 

However, with more chronic conditions, such as asthma, that require ongoing steroid treatments a person very well may need to begin managing blood sugar as if you were treating Type 2 diabetes. In fact, in many cases of long-term steroid use, Type 2 diabetes will develop and when it does a person will require lifelong diabetes management with regular blood sugar testing and most likely a medication treatment program. 

Symptoms of steroid-induced diabetes

The symptoms of steroid-induced diabetes are the same as those for Type 2 diabetes. While taking steroids, you might notice:

– dry mouth and increased thirst

– blurry vision

– frequent urination

– unexpected weight loss

– nausea that may be accompanied by vomiting

– exhaustion

If you are taking any form of doctor-prescribed steroids and experience any of these symptoms, consult your physician right away. You may need a blood test to determine blood sugar levels and whether you are suffering from steroid-induced diabetes.

Steroids and those who have been diagnosed with diabetes

If you’ve already been diagnosed with diabetes, you’re probably wondering how steroids might impact your treatment program. Just as with anyone taking steroids, you may experience an elevation in blood sugar. This, of course, can make managing your diabetes a bit more challenging. 

It really depends on the type of steroid you’re taking and how often. For example, prednisone usually only raises blood sugar for the part of the day it’s taken. So, if you test your blood sugar before taking a morning dose, it will likely be within your desired range. After taking the medication, however, you may notice a spike as the prednisone has increased your insulin sensitivity.

Spikes caused by steroids may require you to adjust your insulin dosage and timing to avoid hyperglycemia and reduce the possibility of more serious issues, such as diabetic ketoacidosis. 

Your diabetes physician and care team will be instrumental in helping you navigate any necessary adjustments to your diabetes testing and management plan. Remember, never make any changes to your diabetes treatment without first consulting your physician.

Some common recommendations for those with diabetes who are prescribed steroids include:

  1. Drink plenty of water to stay hydrated and avoid juices and colas.
  1. Test your glucose level several times a day, whether with a glucose meter and test strips or a prescribed continuous glucose monitoring device (CGM) 
  1. The American Diabetes Association (ADA) also advises checking your urine for ketones every 4-6 hours if your glucose tests above 240 mg/dL. You can do this at home using a simple ketone test kit.
  1. Do not stop any prescribed steroid medication early, unless directed by your physician.
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