Individuals with diabetes can take steroids, but it requires careful management and close medical supervision. Steroids, specifically corticosteroids, are powerful medications prescribed to reduce inflammation and suppress the immune system, treating conditions like asthma, arthritis, inflammatory bowel disease, and autoimmune disorders. While beneficial, they can significantly influence blood sugar levels, making understanding these implications important for anyone with diabetes needing steroid treatment.
How Steroids Influence Blood Sugar
Corticosteroids, such as prednisone or dexamethasone, are synthetic versions of cortisol, a hormone naturally produced by the body. These medications elevate blood sugar levels through several physiological mechanisms. They increase insulin resistance, making the body’s cells less responsive to insulin, the hormone responsible for moving sugar into cells for energy. Steroids also stimulate the liver to produce and release more glucose into the bloodstream.
This combined effect can lead to hyperglycemia, even in individuals with previously well-controlled diabetes. Systemic steroids, taken orally or by injection, have a more significant impact on blood sugar than localized forms like inhaled steroids or topical creams. However, high doses or prolonged use of any form can still pose a risk. The extent of blood sugar elevation varies based on the steroid dose, duration of use, and individual patient factors.
Strategies for Blood Sugar Management
Managing blood sugar while taking steroids requires proactive and consistent effort. Increased blood glucose monitoring is important, often needing checks before each meal and at bedtime. Keeping a detailed record of these readings helps the medical team identify patterns and make necessary adjustments.
Adjustments to diabetes medication are frequently needed. Individuals on insulin will likely require increased doses, and those on oral medications may also need changes or even temporary insulin therapy. The blood sugar increase typically occurs a few hours after taking oral steroids, often peaking in the afternoon and evening if the steroid is taken in the morning. This “steroid curve” means medication adjustments might focus on covering these higher post-meal blood sugar levels.
Dietary modifications can also support blood sugar control. Focusing on low-glycemic foods, such as non-starchy vegetables, lean proteins, and whole grains, can help. Limiting sugary foods, refined carbohydrates, and sugary drinks is advised. Physical activity, as tolerated, can further aid in glucose management by improving insulin sensitivity. Any changes to medication or diet must be made under the guidance of a healthcare professional.
Recognizing and Addressing Potential Complications
While blood sugar fluctuations are a primary concern, steroid use in diabetics can lead to other complications. Steroids suppress the immune system, increasing the risk of infections, including bacterial, viral, and fungal types. This immunosuppression makes diabetics more vulnerable, as they often have a higher baseline risk of infection.
Other potential effects include fluid retention, manifesting as swelling in the lower legs, and elevated blood pressure. Mood changes, ranging from anxiety to depression, are also possible. With prolonged use, steroids can contribute to long-term issues such as bone density loss, increasing osteoporosis risk, and the development of cataracts or glaucoma. These potential complications highlight the importance of careful monitoring beyond just blood sugar.
Collaborating with Your Healthcare Team
Effective management of diabetes while taking steroids relies heavily on strong collaboration with your healthcare team. Inform all healthcare providers, including specialists and pharmacists, about your diabetes status and any steroid prescriptions. This ensures a coordinated approach to your care and allows them to anticipate and address potential issues.
Your healthcare team will work with you to develop a personalized management plan tailored to your specific needs, considering the steroid type and dose, and your existing diabetes treatment. This plan will likely involve adjustments to your diabetes medication and frequent blood sugar monitoring. Clear communication about your blood sugar readings, any new symptoms, or concerns is important.
Avoid self-adjusting medication doses, as this can lead to dangerous blood sugar fluctuations. Seek immediate medical attention if you experience severe symptoms of high blood sugar, such as extreme thirst, frequent urination, or blurred vision.