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How To Lower Blood Sugar After Cortisone Injection

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Higher blood sugar after taking steroid (prednisone, Medrol, Decadron), what should I do?

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How Steroids Affect Blood Sugar

Steroids mimic cortisol, which is a stress hormone. Cortisol raises blood sugar and blood pressure.

Steroids can make the body more insulin-resistant over time. This means that cells dont respond to the hormone insulin the way they should, or the body isnt making enough insulin.

As a result, insulin resistance can occur, as the liver is releasing too much sugar, making the pancreas release more insulin to compensate. Over time, this can cause the pancreas to stop producing insulin, resulting in high blood sugar.

If steroids arent taken for a long time, then blood sugars can return to normal once the steroids are discontinued. However, for people taking steroids long-term, the risk of insulin resistance increases.

For those with diabetes, blood sugars often noticeably increase after steroids are administered. Those without diabetes may be unaware that their blood sugars are elevated since they dont typically check their blood sugar levels.

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What Would A Doctor Prescribe Steroids For

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Doctors prescribe steroids for many issues, including but not limited to treating the inflammation and pain associated with rheumatoid arthritis, lupus, asthma, and common allergies.

In more serious cases, steroids help treat Addisons disease, when the body lacks the ability to produce corticosteroid, that the body needs for proper functioning.

Steroids are also used to suppress the immune system to prevent organ rejection in transplant recipients.

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What Is Cortisone Used For

Cortisone shots can be used to treat inflammation of small areas of the body, like inflammation of a specific joint or tendon. They can also treat inflammation that’s widespread throughout the body, like when you have allergic reactions, asthma, and rheumatoid arthritis, which affects many joints.

Your doctor may prescribe a cortisone shot for:

  • Back pain

  • Tendinitis

How Long Do They Last

Steroid shots usually last up to one or two months. However, they can last longer, especially when used with other treatments such as physical therapy. Injections for certain conditions, such as acute joint pain, may also last longer.

Its best to limit steroid injections to three or four times a year. More frequent injections can cause the skin and bone around the injection site to weaken.

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Changing Your Diabetes Treatment

You may need to change the way you control your diabetes:

  • If you use your diet to control your diabetes, you may need to start taking tablets to control your blood sugar.
  • If you already take tablets, you may need to increase the dose or start using insulin for a short time.
  • If you already use insulin, you may need to increase the dose or use a different type of insulin.

Correction doses of insulin can be used to reduce very high blood sugars. These may not work as well when you are taking steroids. Your diabetes team can give you advice. They may suggest you take more insulin.

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Medications That Are Often Used To Treat Steroid

  • Metformin metformin is commonly used as the first treatment for new diabetes. It is in a drug class called biguanides, and it helps the liver to release less sugar. One of the benefits of metformin is that it doesnt cause low blood sugar. It can cause gastrointestinal side effects, but starting with a low dose and increasing slowly can help minimize side effects.
  • Sulfonylureas this class of diabetes medication helps the pancreas release more insulin, so low blood sugar is a possible side effect.
  • GLP-1 receptor agonists this type of injectable medication helps the body produce more insulin while also reducing the release of sugar from the liver.
  • DPP-4 inhibitors theseoral diabetes medications help the body release more insulin, which helps lower blood sugar.
  • Insulin when the body isnt making enough insulin, injecting insulin is one of the most efficient ways to help lower blood sugar. Still, it does come with the largest risk of low blood sugar out of all diabetes medications, so it should be used carefully and under the supervision of a healthcare provider.

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Tips For Diabetes Management While On Steroids

Both Scheiner and Bell say they find it surprising how few PWDs actually know about these steroid effects on glucose levels and how many healthcare professionals dont explain the likely effects to someone with diabetes before giving a steroid injection or prescription.

The advice that PWDs who might be taking steroids should be getting is pretty clear, per this Medical News Today report:

  • Check blood glucose levels more often than usual. Experts recommend doing this four or more times a day.
  • Work with your doctor to increase the dosage of insulin or oral D-medication, depending on blood sugar levels and other health considerations.
  • Monitor urine or blood ketones to be sure BG levels arent approaching dangerously high.
  • See a doctor immediately if BG levels do rise too high while taking steroids, and increased insulin or oral medication doses do not bring the levels down.
  • As a person gradually reduces their dosage of steroids, they should also reduce the equivalent dosage of insulin or oral medication until it returns to the original dosage. It is important never to stop taking steroids suddenly, as this may cause severe illness.
  • Carry glucose tablets, juice, or candy at all times, in case blood sugar levels drop suddenly from the additional D-medication being taken.

In addition to that textbook advice, Scheiner adds some practical tips:

Bell says dealing with these steroid-related BG rises usually means increasing short-acting insulin and/or insulin pump basal rates.

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