Corticosteroids are a class of medications resembling cortisol, a hormone naturally produced by the body’s adrenal glands. These powerful anti-inflammatory and immunosuppressive drugs are prescribed for a wide range of conditions, including asthma, arthritis, and autoimmune diseases. While highly effective, a notable side effect of corticosteroids is their influence on blood sugar levels. This impact can occur in individuals both with and without a prior diagnosis of diabetes.
How Steroids Elevate Blood Sugar
Corticosteroids interfere with normal glucose metabolism through several physiological mechanisms, leading to increased blood sugar. One primary way is by promoting gluconeogenesis, which is the liver’s increased production of glucose from non-carbohydrate sources like amino acids and fats. This means the liver releases more sugar into the bloodstream than it would.
These medications also induce insulin resistance in various tissues, including muscle and fat cells. Insulin helps glucose move from the bloodstream into cells for energy. When cells become insulin resistant, they do not respond effectively to insulin, causing glucose to build up in the blood.
Corticosteroids can impair the pancreas’s ability to secrete insulin. The combined effect of increased glucose production, reduced glucose uptake, and impaired insulin secretion can significantly raise blood sugar. Common forms of corticosteroids, such as prednisone and dexamethasone, are known to have these effects, with longer-acting types like dexamethasone potentially causing more pronounced hyperglycemia.
Recognizing High Blood Sugar While on Steroids
Individuals taking corticosteroids may experience signs of high blood sugar, also known as hyperglycemia. These symptoms include:
- Increased thirst and frequent urination, as the body attempts to flush out excess glucose.
- Persistent fatigue, resulting from cells not receiving enough glucose for energy.
- Blurred vision, caused by fluid shifts in the eye’s lens.
- Increased hunger.
Monitoring blood sugar is important, especially for those with pre-existing diabetes or higher risk factors like being over 50, overweight, or having a family history of diabetes. Any of these symptoms should prompt a discussion with a healthcare provider to assess blood sugar levels.
Managing Blood Sugar While on Steroids
Managing blood sugar while on corticosteroids requires close collaboration with a healthcare provider. Regular blood sugar monitoring provides data to guide treatment decisions. The frequency of checks may vary depending on the steroid dose and individual response.
Lifestyle adjustments help control steroid-induced hyperglycemia. Dietary modifications, such as reducing simple carbohydrates and sugary foods, can help manage blood sugar fluctuations. Engaging in regular physical activity, if medically appropriate, also supports glucose uptake by cells and can improve insulin sensitivity.
Doctors may adjust existing diabetes medications or prescribe new ones to manage elevated blood sugar. This can include insulin therapy or oral hypoglycemic agents. The specific medication and dosage will depend on the type and duration of corticosteroid used, as well as the individual’s blood glucose levels and response to treatment. Steroid-induced hyperglycemia is often temporary and may resolve after treatment, but careful management is necessary throughout.