A cortisone injection, a common treatment for inflammation, often leads to a temporary rise in blood sugar levels, known as steroid-induced hyperglycemia. This effect is a predictable physiological response to the medication, not typically a sign that underlying diabetes has worsened. The temporary increase in glucose is particularly pronounced for individuals managing pre-diabetes or established diabetes. This blood sugar increase is usually self-limiting and resolves once the injected medication leaves the system. Understanding this temporary shift is the first step toward managing the spike effectively and safely.
How Cortisone Affects Glucose Levels
Cortisone, a synthetic version of the stress hormone cortisol, functions by mimicking its effects. Cortisol is a glucocorticoid that changes how the body manages energy, primarily affecting the liver and cellular response to insulin. The first mechanism is the stimulation of gluconeogenesis, the liver’s production of new glucose from non-carbohydrate sources. Cortisone signals the liver to increase this output, flooding the bloodstream with extra sugar.
The second mechanism is temporary insulin resistance in muscle and fat cells. Insulin unlocks cells to allow glucose to enter for energy. Cortisone makes these peripheral cells less responsive to insulin, so glucose remains circulating in the blood instead of being absorbed. Increased glucose production combined with decreased clearance results in the characteristic rise in blood sugar after the injection.
Understanding the Blood Sugar Timeline
The blood sugar spike following a cortisone injection follows a predictable pattern related to the medication’s absorption and peak action. The rise in glucose levels typically begins within 6 to 12 hours after the injection, when the steroid starts exerting its systemic effects.
Glucose levels usually reach their peak elevation approximately 24 to 48 hours after the injection. During this peak window, the body experiences the maximum effect of the steroid on liver output and insulin resistance. Frequent monitoring during this period is important for glucose control.
The duration of elevated blood sugar depends on the specific corticosteroid used and the individual’s metabolic health. For most patients, the glucose effect gradually subsides over three to five days. However, in individuals with poorly controlled diabetes, the effects can linger for up to seven to ten days before returning to baseline.
Practical Adjustments to Lower Glucose
Immediate lifestyle modifications can mitigate the rise in blood sugar caused by the cortisone injection. Dietary adjustments should focus on selecting foods that release glucose slowly. Prioritize low-glycemic index carbohydrates, such as whole grains and legumes, which prevent rapid blood sugar surges.
Increase your intake of protein and dietary fiber, as both nutrients slow down carbohydrate digestion and absorption. Foods high in protein and fiber also promote satiety, which can help manage the increased appetite sometimes associated with steroid use. Maintaining sufficient hydration by drinking plenty of water helps the kidneys flush out excess glucose.
Regular physical activity is an effective way to lower blood sugar without relying solely on insulin. Muscle contractions during light to moderate exercise, such as walking or cycling, stimulate a separate pathway to pull glucose into the muscle cells. This action bypasses the temporary insulin resistance caused by the cortisone, making movement a helpful tool.
Aim for short, frequent bouts of activity, such as a 10-to-15-minute walk after each meal, to maximize glucose uptake. However, if blood sugar levels are elevated above 250 mg/dL, avoid intense or strenuous exercise. High glucose levels combined with intense activity can trigger the production of ketones, a potentially dangerous metabolic state.
When to Consult Your Healthcare Provider
Monitoring blood sugar levels frequently is the most important self-care action following a cortisone injection, especially for those with diabetes. Check glucose levels four or more times daily for the first five to seven days post-injection to track the spike proactively. Maintaining blood glucose readings below 180 mg/dL is a common target range during this temporary period.
If you have diabetes, your existing medication regimen will likely need temporary adjustment under the guidance of a healthcare professional. This may involve increasing the dosage of oral medication or adjusting the basal and bolus rates of insulin therapy. These changes must be directed by your doctor to ensure safety and prevent dangerously low blood sugar once the cortisone effect wears off.
You should contact your healthcare provider if your blood sugar consistently remains above 200 mg/dL despite lifestyle adjustments and pre-approved medication changes. Seek immediate medical attention if you experience signs of severe hyperglycemia, such as persistent vomiting, extreme thirst, or shortness of breath. These symptoms can indicate a more serious condition, like diabetic ketoacidosis, particularly if readings are consistently above 300 mg/dL.