Corticosteroids, commonly referred to as steroids, are a class of medications widely used for their anti-inflammatory and immunosuppressant properties. These synthetic drugs mimic cortisol, a natural adrenal hormone involved in the body’s stress response. Healthcare providers prescribe them to manage various conditions, including autoimmune disorders like lupus, inflammatory conditions such as arthritis, severe asthma, and allergic reactions. While beneficial for treating these ailments, a side effect of corticosteroids is increasing blood glucose levels, a condition known as steroid-induced hyperglycemia. This can occur in individuals with or without a prior diabetes diagnosis.
How Steroids Affect Blood Sugar
Corticosteroids influence blood sugar through several mechanisms. They primarily increase the liver’s production of glucose, known as gluconeogenesis, by converting non-carbohydrate sources like amino acids into sugar. This leads to the liver continuously releasing glucose into the bloodstream, even when not immediately needed.
These medications also reduce the body’s sensitivity to insulin, which moves glucose from the blood into cells for energy. This decreased sensitivity, known as insulin resistance, makes cells less responsive to insulin, leading to more glucose remaining in the bloodstream. Consequently, more insulin is required for blood glucose control. Corticosteroids can also impair glucose uptake by muscle and fat cells, further elevating blood sugar.
Who Is Affected and What to Watch For
Individuals with pre-existing diabetes, whether type 1 or type 2, are at a higher risk for blood sugar increases when taking corticosteroids. Those with pre-diabetes or a family history of diabetes also risk developing steroid-induced hyperglycemia. Other factors like older age, a high body mass index, and high blood pressure also increase susceptibility.
For some individuals, corticosteroids can lead to a new diagnosis of diabetes, often temporary and resolves after discontinuing the medication. Common symptoms of high blood sugar include increased thirst, frequent urination, and feeling more tired than usual. Other signs include blurred vision, dry mouth, or unintentional weight loss.
Strategies for Managing Blood Sugar on Steroids
Managing blood sugar while taking steroids involves dietary adjustments and other approaches. Limiting refined carbohydrates, sugary drinks, and highly processed foods prevents rapid blood glucose spikes. Focusing on whole grains, vegetables, and lean proteins, along with portion control, supports stable blood sugar. Eating regular meals and avoiding skipping meals contributes to better glucose management.
Regular blood sugar monitoring is important for at-risk individuals or those advised by their doctor. This allows early detection of elevated levels and timely intervention. Appropriate physical activity, advised by a healthcare provider, can also improve insulin sensitivity and lower blood glucose.
Adhering to the prescribed steroid dosage and schedule is important, as higher doses impact blood sugar more. For individuals with existing diabetes, medication adjustments may be necessary. This may involve increasing insulin doses or adjusting oral medications to counteract the steroid’s effects.
When to Seek Medical Guidance
It is important to seek medical guidance if blood sugar levels are consistently high or unexpectedly elevated while taking corticosteroids. The development of new symptoms of high blood sugar, such as increased thirst or frequent urination, warrants consultation with a healthcare professional. Any concerns about the steroid dosage or duration should also be discussed with your doctor.
Always consult a healthcare provider before making any changes to medication or diet plans. Informing all healthcare providers about current steroid use is important, as this allows for comprehensive management and and avoids potential drug interactions or complications.