Prednisone, a widely prescribed corticosteroid, is often used to reduce inflammation and suppress the immune system in various conditions like asthma, allergic reactions, and autoimmune disorders. While effective, it is known to have several side effects. One significant concern for patients is its potential impact on blood sugar levels.
The Link Between Prednisone and Blood Sugar
Prednisone can cause an increase in blood sugar, a recognized side effect known as “steroid-induced hyperglycemia” or “steroid-induced diabetes.” The elevation can range from a mild, temporary increase to new-onset diabetes in individuals with previously normal blood sugar levels. For those already living with diabetes, prednisone can worsen existing glucose control.
How Prednisone Elevates Blood Sugar
Prednisone influences blood glucose levels through several biological mechanisms. It primarily increases the production of glucose by the liver, a process known as gluconeogenesis. This means the liver releases more sugar into the bloodstream than it typically would.
In addition to increased glucose production, prednisone also reduces the body’s sensitivity to insulin, a condition called insulin resistance. Insulin is the hormone responsible for moving sugar from the blood into cells for energy. When cells become resistant to insulin, less sugar is absorbed from the bloodstream, leading to higher circulating glucose levels. Prednisone can also affect the pancreas’s beta cells, which produce insulin, potentially decreasing their ability to release insulin effectively.
Identifying and Managing High Blood Sugar
Common symptoms of hyperglycemia include increased thirst, more frequent urination, fatigue, and blurred vision. Some individuals might experience these symptoms, while others may have high blood sugar without noticeable signs.
If you are taking prednisone, your doctor might recommend monitoring your blood sugar levels, especially if you are at higher risk for developing hyperglycemia. Management often involves close communication with your healthcare provider, who may suggest dietary adjustments like reducing simple carbohydrates. Regular physical activity can also play a role in managing blood sugar. In some cases, temporary medication, such as insulin or oral glucose-lowering agents, may be prescribed to help control blood sugar while on prednisone.
Risk Factors and Prevention
Certain factors can increase an individual’s susceptibility to prednisone-induced hyperglycemia. These include having pre-existing diabetes or prediabetes, a family history of diabetes, obesity, and older age. The dose and duration of prednisone use also play a role, with higher doses and longer treatment periods generally correlating with a greater risk.
Regular blood sugar monitoring, particularly if you have identified risk factors, allows for early detection and intervention. Maintaining a healthy diet and engaging in regular exercise can support blood sugar control. Open communication with your prescribing doctor about any concerns or symptoms is also important.