Tuesday, December 5, 2023

Why Do Steroids Make Your Blood Sugar Go Up

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How Long Does It Take For Blood Sugar To Return To Normal After Prednisone

The Bad of Corticosteroids | Johns Hopkins

Steroid users should keep a close eye on their blood sugar levels and may need to take oral medicine or insulin if they get too high. In general, blood sugar levels should return to normal within 1-2 days of completing steroid medication. However, if you have diabetes then you should check your blood sugar more frequently than this.

Here are some examples of conditions that can cause blood sugars to be low:

Exhaustion/stress: Excessive stress and exhaustion can lead to low blood sugar because the body uses up its energy reserves.

Illness: A cold or the flu can cause blood sugars to go down. This is because viruses use up energy producing cells so the remaining cells work harder to produce more adrenaline and cortisol which controls sugar in the blood. When someone gets better they start using these energy reserves so blood sugars will rise back to normal.

Pregnancy and breast-feeding: During pregnancy and breast-feeding, women tend to have lower blood sugars because hormones control glucose metabolism differently during these times. Women who have diabetes should discuss with their doctors how to manage their condition while pregnant or breast-feeding.

Lifestyle factors: A poor diet and lack of exercise can lead to high blood sugars and potentially cause them to rise again when taking steroids.

What Should I Keep In Mind While Taking Steroids

If youre using an insulin pump, the basal rate can be increased slightly for part of the day, if needed. You can do this using a temporary basal rate. If you are using the MiniMed 670G system, ask your provider if you should switch to Manual Mode during the time you are taking the steroid. One of the best ways to determine if you need a higher basal rate is by monitoring your glucose level using a continuous glucose monitor such as the Guardian Connect system or MiniMed insulin pump systems.

Consider how many days you will be taking the steroid. If you only take the steroid for a few days, the long-term impact of hyperglycemia is unknown. But you do want to avoid short-term consequences of high glucose such as dehydration or diabetic ketoacidosis 5:

  • Be sure to stay well hydrated with sugar-free beverages.
  • Check your glucose several times per day and as directed by your healthcare team.
  • According to the American Diabetes Association, experts advise checking for ketones every 4-6 hours when your glucose level is above 240 mg/dL. Let your healthcare provider know if you have ketones in your urine, especially if the level is moderate or higher.
  • Talk with your provider about your insulin dose and always follow their advice. If you do increase your insulin dose while you are taking steroids, be sure to go back to your usual dose when you stop taking the steroids.
  • Do not stop your steroid medication early, unless recommended by your healthcare provider.


Medications That Are Often Used To Treat Steroid Induced Diabetes Include:

  • 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 these oral 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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How Do Oral Steroids Affect My Glucose Levels

Individuals who find themselves taking oral steroids like predisone for a medical condition are likely to see their blood sugar go haywire while on the medication. There are many different ways of getting steroids in the body, like oral , inhaled, liquid drops , topical , and intravenous. Depending on the condition, a particular route may be favored over another. For a poison ivy rash, a cream might be ideal. For severe asthma, inhaled or intravenous might. For chronic sinusitis, oral pills may be prescribed. For styes, a eyedropper liquid form might be used. Oral and intravenous are the mostly likely to have a significant effect on glucose levels and metabolism.

Steroids are generally prescribed for their anti-inflammatory and immune suppressing properties, but have several side effects, of which one of the most severe is hyperglycemia .

One of our founders who normally has extremely stable glucose levels had to take a week of prednisone for a respiratory illness. His normal flat line glucose went from this:

Stable, low glucose levels in the 60-70 mg/dL range

to this:

Highly erratic glucose with large swings up to 150 mg/dL

Exaggerated elevation of glucose with slow return to normal

Oral steroids affect glucose regulation through a number of different mechanisms, all of which can lead to increased glucose levels in the blood. Here are some of the main causes:

  • Additional mechanisms, detailed in this paper.
  • What Are Steroids Prescribed For

    How its made: Cholesterol production in your body

    Corticosteroids are hormones similar to those naturally occurring in your body that are produced in response to stress, injury and disease. Steroid medications are prescribed for their anti-inflammatory effect in the body and their ability to suppress the immune system.

    Steroids are commonly used to treat:

    Steroids are also useful to prevent nausea during medical procedures such as chemotherapy.

    These steroids are different to the anabolic steroids that are used to build muscle mass.

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    How Long Does Prednisone Affect Blood Sugar

    The pancreas produces the insulin hormone to help convert sugar or glucose into energy. When insulin is inadequately generated by the pancreas or less efficiently absorbed by the liver cells, the blood sugar levels spike up due to the non-conversion of glucose to energy. Nevertheless, for questions like Does prednisone raise blood sugar? Prednisone can increase the glucose level for a part of the day from its administration time.

    How Glucocorticoids Effect Blood Sugar

    Medications known as glucocorticoids, such as prednisone and cortisone, are mainly used as anti-inflammatories or as anti-rejection drugs. They are prescribed, for example, for an arthritis attack or after an organ transplant. One of their side effects is to increase blood glucose since these drugs promote glucose production in the liver and reduce the sensitivity of the cells to insulin. Consequently, glucose accumulates in the blood and can cause a rise in blood sugar levels. The side-effects vary from person to person based on the prescribed dose of glucocorticoids, the way it is administered , and the length of time a person takes the drug. If you are taking glucocorticoids, measure your blood sugar more often than usual in order to monitor the drugs impact on your diabetes control. It may be necessary to talk to your doctor to adjust your antidiabetes medication or your insulin dosage to maintain normal blood-glucose levels. When glucocorticoids treatment is over, blood glucose levels usually return to normal within a few days. Note: It is essential that the termination of glucocorticoids be supervised by a health professional. Research and text: Amélie Roy-Fleming , Dietitian and Certified Diabetes Educator Scientific review: Louise Tremblay, nurse, M. Ed. September 2014Continue reading > >

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    Did Steroids Bring On My Type 2 Diabetes

    There has been debate as to whether corticosteroids are a cause for diabetes or whether steroids advance the development of existing type 2 diabetes

    A study published in 2012, carried out by the University of Sydney, looked to investigate answers to the question.

    The study, titled Steroid-Induced Diabetes: Is It Just Unmasking of Type 2 Diabetes? , found that those which developed new onset steroid induced diabetes had lower risk profiles than is typical of people with type 2 diabetes.

    Why Does Prednisone Cause High Blood Sugar

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    Prednisone and other steroids can induce an increase in blood sugar levels by making the liver insulin resistant. Insulin is produced by the pancreas to regulate blood sugar levels. Diabetes can be caused by a flaw in the way the body reacts to insulin or an issue with insulin synthesis in the pancreas. The most common form of diabetes is based on obesity, age, race, genetics, and lifestyle factors.

    People who take steroids may experience increased blood sugar because this drug class has that effect on everyone. Intentional or not, people often fail to account for diet changes when taking steroids. This can lead to weight gain and elevated blood sugar levels. Additionally, some people are genetically more prone to developing diabetes while taking steroids. Last, but not least, steroids can also cause new-onset diabetes through unknown mechanisms.

    Diabetes can be controlled either by controlling your blood sugar level or by using medication. Your doctor will help you decide what strategy is best for you. In addition to standard medications used to treat diabetes, your doctor may recommend supplements, such as vitamin B12 or chromium, or changes to your diet or exercise routine. Only you can decide what approach will work best for you it’s important to share any concerns or questions with your doctor.

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    When Do Steroids Start To Affect Blood Sugar

    Steroids may start to affect your blood sugar pretty quickly after starting treatment, although it depends on what course of treatment youre on.

    For oral steroids, blood sugars may begin to rise within a few days of treatment. The effects will depend on the dose and type of steroid you are taking.

    Steroid injections start to affect blood sugars soon after the injection and can remain high for 3-10 days afterward.

    If youre taking topical steroid creams or gels or inhaled steroids, they do not typically affect blood sugar levels.

    How Long Does Prednisone Affect Blood Sugar Levels

    Question: How long does prednisone affect the blood sugar of people with diabetes? Answer: The pharmacists tell me that once the drug has been discontinued, the effects on blood glucose should disappear within just a few days. Many of my patients, however, say that their blood glucose remains elevated for quite a long time. This difference may be explained, in part, by weight gain that is common with prednisone use. Gaining weight likely worsens insulin resistance resulting in higher blood glucose readings even after the effects of the drug have worn off. Additionally, type 2 diabetes is progressive. Over time, most people with type 2 diabetes experience higher blood glucose readings unless they are treated with additional medications or higher doses of current medications. Jill Weisenberger, MS, RD, CDE is the author of Lose Weight with Diabetes Week by Week . She serves as contributing editor of Environmental Nutrition. A recognized speaker and consultant, she is recognized for her practical advice and desires to help others improve their eating habits, to lose weight and to live healthier lives.Continue reading > >

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    How Is Steroid Induced Diabetes Diagnosed

    Steroid induced diabetes is diagnosed with a finger prick test for a small sample of blood to look at the blood glucose concentration and this will be checked by a specialist team as an inpatient or outpatient. If a child or young person has a fasting blood glucose above 7 mmol/L or a random blood glucose above 11.1 mmol/L, they have diabetes.

    Insulin Not Working After Steroid Injection

    Blood Under Toenail Diabetes

    insulin not working after steroid injection insulin not working after steroid injection Hi, Please can anyone offer some advise. I was given a steroid injection 5 days ago. I know have high readings and my insulin is not working. Is there anything I can do to make it work? Thanks D.D. Family T1 since February 1980, new to insulin pump. It’s not unusual for you to have high readings after a steriod injection. I recently had one and my blood sugars were off for about a week. Are you sure your insulin isn’t working? You probably need more of it while you are recovering from the injection. They do make the sugars go up. My injection was a low dose of steriod so that it wouldn’t mess my sugars up too much. If you had a full injection you may be messed up longer than I was. How high are your blood sugars going? Are they coming down at all? What doesn’t kill you makes you stronger. Shouldn’t I be invincible by now? Started Paradigm 722 on 1-12-07 with apidra! Hi, I am normally 4-7 and now they are around 15. I have doubled my dose . Yesterday I gave myself insulin and didnt eat and my reading were the same after as they were before. I have had ketones on and off for 4 days and my eyes are blurred.Continue reading > >

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    Where To Find Support

    If youre feeling worried, or if youve got more questions about steroid-induced diabetes, were here to help.

    You can give our confidential helpline a call and talk to one of our highly trained advisors. Or you can hear from other people with the condition in our online support forum. You dont need to sign up to read about their experiences, but you will need to become a member if youd like to reach out and speak to them.

    How Do Steroids Induce Or Bring On Diabetes

    Normally, the liver reduces the amount of glucose it releases in response to insulin. Steroids make the liver less sensitive to insulin so it carries on releasing glucose even if the pancreas is releasing insulin. Steroids also stop glucose being absorbed by muscle and fat in the body so it circulates in the blood stream. Steroids reduce the bodys sensitivity to insulin and therefore more insulin is required to transport the glucose into the cells.

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    How Steroids Affect Your Blood Glucose Levels

    If you have type 1 or type 2 diabetes, taking steroids could make it harder for you to control your diabetes. Steroids raise your blood glucose levels in the following ways:

    • They block the action of insulin which causes insulin resistance
    • Less glucose is taken up by the muscles from the bloodstream
    • They cause the liver to start releasing extra glucose into the bloodstream

    Steroids Are Available In Different Forms

    Epidural Steroid Injections
    • Injections which can be into blood vessels, joints or muscles
    • Inhalers such as mouth or nasal sprays
    • Lotions, gels or creams

    Inhaled steroids used for asthma do not affect blood glucose levels.

    Oral steroids will have an effect depending on time, dose and type of steroid you are taking. These effects may be seen in your blood glucose readings a few days after commencement.

    Injectable steroids can cause blood glucose readings to rise soon after administration and the effects may last from three to 10 days.

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    If You Already Have Diabetes

    If you have diabetes and you are prescribed steroids, then you may notice a rise in your blood glucose levels, which will usually mean that your diabetes treatment needs to be adjusted. It is important that you check your blood glucose levels regularly. If you are concerned that your diabetes is getting out of control while you are on steroids, contact your diabetes care team.

    Your blood glucose level may rise 2448 hours after your first steroid injection or first dose of tablets, although this may be temporary. Inhaled steroids and steroid skin creams are unlikely to increase your blood glucose levels.

    If your steroid treatment is intermittent, e.g. if you only take it with an acute recurrence of your illness, you may need to be on a different diabetes treatment while you are taking steroids.

    If you have been on large doses of steroids but these doses are reduced as you get better, then treatment for your diabetes will also need to be reduced or you will be at risk of hypoglycaemia .

    You may need to take steroids on a permanent basis. If so you will be reviewed by your GP or may be asked to attend the diabetic clinic at the local hospital.

    Understanding Steroids And Diabetes

    Steroids are used to treat various conditions where there is inflammation in the body. They work by reducing this inflammation. Some examples of the conditions they are used to treat are:

    • Rheumatoid arthritis
    • Some types of malignant diseases
    • A few other auto-immune conditions

    There are many different types of steroids. Some of the more common steroid drugs include:

    • Prednisolone
    • Deflazacort

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    Steroid Medications And Diabetes Fact Sheet

    Some people with diabetes may need to take steroid medications to help manage other conditions, such as asthma, arthritis, autoimmune diseases, and dermatitis, or as part of chemotherapy. Steroid medications can increase blood glucose levels.

    Read more in our fact sheet Steroid medications and diabetes .

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