Prednisone is a widely prescribed corticosteroid medication used for its powerful anti-inflammatory and immunosuppressant effects. It treats conditions like asthma, allergic reactions, arthritis, and autoimmune diseases. A common concern for individuals taking this medication is its potential impact on blood sugar levels, an effect that is often temporary.
How Prednisone Affects Blood Sugar
Prednisone influences the body’s glucose regulation, leading to elevated blood sugar, sometimes called “steroid-induced diabetes” or “steroid-induced hyperglycemia.” This happens because prednisone, a synthetic glucocorticoid, mimics cortisol, a hormone naturally produced by the adrenal glands. Elevated cortisol influences metabolism and can disrupt normal blood sugar control.
Prednisone primarily affects glucose levels by causing the liver to release more glucose into the bloodstream. It also reduces the body’s sensitivity to insulin, a hormone that helps transport sugar from the blood into cells for energy. This leads to insulin resistance, meaning cells do not absorb glucose effectively, causing sugar to build up in the blood.
Identifying the Risk
Several factors increase the risk of developing high blood sugar while on prednisone. The dosage and duration of treatment play a role; higher doses and longer periods of use increase the risk. For instance, doses of 7.5 mg daily or higher are associated with increased risk.
Pre-existing health conditions also contribute to this risk. Individuals with a family history of diabetes, those who are overweight or obese, or people with prediabetes or metabolic syndrome are more susceptible. Age is another factor, with individuals over 40 (or over 25 for certain ethnic backgrounds) having a higher risk.
Recognizing the Signs
Individuals taking prednisone should be aware of signs of elevated blood sugar. These include increased thirst and more frequent urination, particularly at night. Persistent fatigue or unusual weakness are also indicators.
Other symptoms include blurred vision and an increase in hunger. While some people may experience these symptoms, blood sugar levels can also be high without noticeable signs. Therefore, awareness of these signs is important for those on prednisone.
Managing Blood Sugar While on Prednisone
Managing blood sugar while on prednisone involves several strategies, often under medical supervision. Regular blood sugar monitoring is recommended, with healthcare providers suggesting checks multiple times daily, especially in the initial days of treatment. This helps track the medication’s effect and informs any necessary adjustments.
Dietary modifications are important for management. Reducing simple carbohydrates and focusing on nutritious foods like vegetables, whole grains, and lean proteins can help stabilize blood sugar levels. Limiting fruit intake and avoiding afternoon snacks may also be beneficial, as blood glucose can be harder to control during these times.
Engaging in regular physical activity, if medically appropriate, can improve insulin sensitivity and help regulate blood sugar. In some cases, lifestyle changes alone may not be sufficient, and healthcare providers might prescribe oral antidiabetic medications like metformin or sulfonylureas, or even insulin therapy, to control blood sugar levels. Communicate any concerns with healthcare providers, as blood sugar levels usually return to previous levels once prednisone is stopped, though some individuals may develop long-term type 2 diabetes.