Steroids, High Blood Sugar, and Steroid-Induced Diabetes -

Steroids are used to treat a huge number of medical conditions, some of which are common in people with diabetes, including:

Allergy and lung disorders
Muscle and joint pain
Rheumatic conditions, such as rheumatoid arthritis and psoriatic arthritis
Skin diseases, such eczema, hives, and severe psoriasis
Eye allergies and inflammation
Nervous system disorders, such as multiple sclerosis and cerebral edema

“Some people with diabetes may be able to tolerate steroids without needing to adjust treatments or medications, but some people with diabetes may experience high blood glucose levels and will need medication adjustments,” says Grace.

“The steroids that get into your general blood circulation usually have the biggest impact on your blood glucose levels,” says Grace. “Those would be oral steroids, sometimes injectable steroids (if they get outside of where they are injected), and possibly inhaled steroids.” Topical steroids, such as creams and lotions, are less likely to affect blood sugar levels because they do not enter the bloodstream.

Steroid treatment may also bring other changes that affect diabetes management: “Steroids … could cause you to be hungrier and disrupt your sleep,” says Grace. “In addition, most ailments we treat with steroids — knee pain, respiratory problems, etc. — can make physical activity more difficult.” A lack of sleep or exercise can also contribute to rising blood sugar levels, as can a change in your diet.

If you need to start taking a steroid medication, your healthcare team may ask you to adjust your glycemic management strategies, including your dosage of glucose-lowering medications. If you don’t normally use insulin to manage your diabetes, it may be given to you in the hospital along with your steroid treatment. If you already take insulin, you can probably expect to increase your doses while using steroids: “For people with diabetes on insulin, the basal or long-acting dose can be easily adjusted while on steroids,” says Grace.

Other diabetes drugs have proven effective in the treatment of steroid-induced hyperglycemia, and your doctor may also prescribe additional glucose-lowering medications, especially if you have type 2 diabetes.

Because individual responses to steroids can vary so widely, it’s important to collaborate with your healthcare team and monitor your blood sugar. “The key to treating any type of diabetes is knowing what your blood glucose is doing in real time,” says Grace. “The best way to know if you will need to adjust your medications is to monitor your blood glucose levels very closely, preferably with a CGM.”

Source link