Many individuals taking steroids often wonder if these powerful drugs can lead to an increase in their blood glucose. Maintaining stable blood sugar levels is important for overall health, as uncontrolled elevations can lead to complications. This article explores the relationship between steroids and blood sugar, explaining why this interaction occurs and how to manage it.
What Are These Steroids?
The term “steroids” can sometimes be confusing, as it refers to different types of compounds. When discussing steroids and blood sugar, the focus is on corticosteroids, such as prednisone and dexamethasone, not anabolic steroids used for muscle building. Corticosteroids are synthetic versions of cortisol, a hormone naturally produced by the adrenal glands. They are widely prescribed for their potent anti-inflammatory and immune-suppressing properties.
These medications treat a broad range of conditions, including asthma, allergic reactions, autoimmune diseases like lupus and rheumatoid arthritis, and inflammatory bowel disease. While corticosteroids can be administered in various forms, such as oral tablets, intravenous injections, inhaled sprays, or topical creams, systemic forms (oral or intravenous) are primarily associated with significant effects on blood sugar levels because they circulate throughout the entire body.
The Mechanism of Blood Sugar Increase
Corticosteroids can significantly impact glucose metabolism, leading to elevated blood sugar levels. This effect is often termed “steroid-induced hyperglycemia” or, in some cases, “steroid-induced diabetes.” One key mechanism involves increased glucose production by the liver, a process known as gluconeogenesis. Corticosteroids stimulate the liver to release more glucose into the bloodstream, contributing to higher circulating sugar.
Additionally, these medications can reduce the body’s sensitivity to insulin, a condition called insulin resistance. This means that cells in peripheral tissues, such as muscles and fat, become less responsive to insulin’s signals to absorb glucose from the blood. As a result, glucose remains in the bloodstream rather than being taken up by cells for energy or storage. Corticosteroids may also affect the pancreas, potentially impairing its ability to secrete sufficient insulin to counteract these effects. These effects can occur in individuals with or without a prior diagnosis of diabetes, though those with pre-existing diabetes or prediabetes are at a higher risk for more pronounced blood sugar elevations.
Monitoring and Managing Your Blood Sugar
Regular blood sugar monitoring is recommended while taking corticosteroids, particularly for individuals with pre-existing diabetes or prediabetes. This monitoring helps to identify how the medication is affecting glucose levels and allows for timely adjustments to management strategies.
Dietary adjustments also play a role in managing steroid-induced blood sugar changes. Focusing on balanced meals, limiting simple carbohydrates, and maintaining consistent meal times can help stabilize glucose levels. Physical activity, as advised by a healthcare professional, can also be beneficial, as it helps to improve insulin sensitivity and glucose uptake by muscles.
Any changes to diabetes medications, including insulin or oral drugs, must only be made under the guidance of a healthcare professional. Doctors may adjust current medication dosages or add new medications to effectively manage steroid-induced hyperglycemia.
When to Consult a Healthcare Professional
Seek medical advice when experiencing symptoms or concerns related to blood sugar while on corticosteroids. Consistently high blood sugar readings, even without noticeable symptoms, warrant a consultation with a healthcare provider. New symptoms commonly associated with high blood sugar, such as increased thirst, frequent urination, unusual fatigue, or blurred vision, should also prompt immediate medical attention.
Discuss any concerns about the side effects of corticosteroids or if current management strategies are not effectively controlling blood sugar levels with a doctor. Individuals should also report any signs of infection, as corticosteroids can sometimes mask these. It is important to never stop taking prescribed corticosteroids or adjust their dosage without consulting a doctor, as abrupt cessation can lead to serious withdrawal symptoms and potentially worsen the underlying condition.