Corticosteroids, or steroids for short, are common medications prescribed for many diseases, but they can often cause blood glucose problems in diabetic patients.
If you have prescribed steroids, it has been found that blood glucose levels can easily and quickly spike quickly, leading to stubborn hyperglycemia.
In this article, we will explain exactly how steroids affect blood sugar and what you can do about it.
At the end of the article, we will also explain the unusual situation in which steroid therapy is actually possible Cause Type 2 diabetes caused by causing complications called “steroid-induced diabetes.”
What do doctors prescribe steroids?
Doctors prescribe steroids for many issues, including but not limited to treating inflammation and pain associated with rheumatoid arthritis, lupus, asthma, and common allergies.
In more serious cases, steroids can help treat Addison’s disease if the body lacks the ability to produce corticosteroids.
Steroids are also used to suppress the immune system and prevent organ rejection in transplant recipients.
How are steroids used?
There are many ways to take steroids. The most common is the mouth in the form of tablets, capsules or syrup. Steroids can also be taken via inhalers or intranasal sprays to reduce asthma attacks or inflammation from seasonal allergies.
Steroids can also be applied topically in the form of creams and ointments that help to heal skin conditions.
Finally, steroids administered by injection are the most common method of treating the pain and inflammation that people experience when suffering from tendonitis.
What are the side effects of steroids?
Side effects of steroid use vary depending on the type of treatment, dosage, and duration of treatment.
According to Mayo Clinic, side effects of oral steroids include:
- Glaucoma
- Fluid retention
- Hypertension
- Mood fluctuations
- Confusion and memory loss
- Weight gain
When taking oral steroids for a long period of time, you may experience:
- Cataract
- Hyperglycemia or triggered steroid-induced diabetes
- Increased risk of infection
- osteoporosis
- Slow wound healing
- Severe fatigue
- Loss of appetite
- Nausea and muscle weakness
Side effects of inhaled steroids include:
After inhaling the steroids, gargle and rinse your mouth to avoid irritation in the mouth and throat.
Side effects of topical steroids include:
- Thinning of the skin
- Red skin lesions
- Acne
Side effects of injected steroids include:
- Thinning of the skin at the injection site
- Pain at the injection site
- Facial flushing
- insomnia
- Hyperglycemia
Physicians usually limit injections to 3-4 terms per year, depending on the patient.
How do steroids affect blood glucose?
If you prescribe steroids (such as prednisone) and live with diabetes, you will notice that blood glucose levels may result in increased levels (this happens in people with or without diabetes).
If you are prescribing steroid treatments, make sure your doctor knows you have diabetes. Your doctor may be able to prescribe another drug that won’t interfere with your blood sugar level.
Steroids suppress the effectiveness of insulin, cause insulin resistance, and accumulate liver release in the bloodstream.
The combination of these two effects makes it much more difficult to manage blood glucose levels while taking steroids, resulting in higher blood glucose levels, and as a result, much more insulin is required to manage diabetes.
When do steroids start to affect blood sugar?
Steroids will depend on your course of treatment after you start treatment, but they may start to affect your blood sugar quite quickly after you start treatment.
With oral steroids, blood glucose levels may begin to rise within a few days of treatment. The effect depends on the dose and type of steroid you are taking.
Steroid injections can begin to affect blood glucose immediately after injection and can remain high for 3-10 days after the injection.
If you are taking topical steroid creams or gels, or inhaled steroids, they usually do not affect your blood glucose levels.
What to do when starting steroid therapy
If you need to take steroids due to illness, tell your prescriber that you have insulin-dependent diabetes. Talk to your doctor about advice on controlling your blood glucose while taking steroids.
To learn more, it can also be helpful to request an information sheet about the medication you are taking.
Several other strategies for managing steroid therapy in diabetes are:
- Talk to your prescriber about whether you need to adjust your insulin (or other diabetic medication) while using steroids
- Call your endocrinologist and let them know that you are undergoing steroid treatment. Seek advice on managing your blood glucose levels during steroid therapy.
- Check your blood sugar levels more frequently than usual
- Carefully monitor ketones. Blood glucose levels above 250 mg/dl for medium to high ketones should be called to your doctor or visited an emergency care clinic
- If you are experiencing DKA signs or symptoms, seek immediate medical care or call 911
- Always carry extra hypoglycemic snacks with you. Blood glucose levels may suddenly drop during steroid treatment
- Always wear a Medic Alert Bracelet
- Make plans to increase your insulin needs (Make sure to refill your insulin and all CGM and insulin pump supplies)
- Follow your regular diet plan and aim for regular physical activity (have plenty of carbohydrate snacks and meals on hand, and have an exercise plan to relieve higher blood sugar levels)
What to do when stopping steroid therapy
It is important to know what to do when stopping steroid therapy, especially when managing diabetes, to avoid negative health effects.
Some strategies to help you stop steroid therapy include:
- Work with your endocrinologist on tapering the amount of insulin you take every day to reflect your steroid use (this is important to avoid potentially dangerous hypoglycemia).
- Do not stop taking steroid therapy immediately. Work with your prescribing doctor to taper your medication. If you suddenly stop steroid therapy, you will become very sick.
- Taper your steroid therapy and check your blood glucose levels more frequently than usual
- Blood glucose fluctuates are common, which causes other medications to be tapered, thus carrying extra low snacks
- If your blood sugar level is high for 2-3 days or more after stopping steroid therapy, contact your doctor immediately.
What is steroid-induced diabetes?
People who are at high risk of developing type 2 diabetes and who have been on steroid therapy for a long period (more than three months) can develop complications called steroid-induced diabetes.
There has been a lot of debate in the medical field about whether steroids are responsible for diabetes, or whether steroids will advance the development of patients’ existing type 2 diabetes.
A study published in 2012 at the University of Sydney found that people with new onset steroid-induced diabetes had a lower risk profile than typical people with type 2 diabetes, meaning steroid therapy played a role in the development of the disease.
Hyperglycemia levels during steroids can subside after stopping taking medication. However, some people may develop type 2 diabetes. This needs to be managed for the rest of your life.
Symptoms of steroid-induced diabetes
If you experience any of the following symptoms during long-term steroid use, consult your doctor immediately: This can be a sign of steroid-induced diabetes.
- Dry the mouth
- Extreme thirst
- Fatigue
- Unintended weight loss
- Frequent urination
- Blurred vision
- Nausea and vomiting
- Dry and itchy skin
- Throbbing/loss of emotions in the hands and/or feet
Steroid therapy can cause a variety of side effects. This can be particularly troublesome for diabetics.
They also relieve inflammation, pain and discomfort in many different diseases and conditions.
You can work with your doctor to make choices that minimize hyperglycemia, reducing the risk of serious complications and enjoying the benefits of steroid treatment.
