The Effects of Steroids on Blood Sugar Levels

Effects of Steroid

What exactly are steroids?

The term “steroid” refers to a general term; the term “glucocorticoid” refers to a medical term that is more specific. Glucocorticoids are hormones that are naturally produced in the body (by the adrenal glands of the kidneys) and have anti-inflammatory properties. They also have the ability to regulate metabolism (which includes glucose metabolism). In addition to the naturally occurring steroids produced by the body, there are synthetic versions available that are designed to act like hormones and reduce inflammation in the body. Prednisone, hydrocortisone, and dexamethasone are some of the generic names for glucocorticoids that have the ability to affect the entire body system (also known as systemic effects). Glucocorticoids inhaled into the lungs have a direct effect on the lungs, and these medications include beclomethasone, budesonide, and fluticasone. The use of inhaled glucocorticoids is indicated for the treatment of asthma and long-term lung conditions such as Chronic Obstructive Pulmonary Disease (COPD). Topical glucocorticoids are also available in the form of lotions or creams, and these include hydrocortisone and betamethasone, among others. In this article, we will concentrate on systemic (i.e., oral, injected, or inhaled) glucocorticoids, which we will refer to as “steroids,” because they are the ones that are most likely to have an impact on blood glucose levels.

If I am prescribed steroids and I have diabetes, what should I do?

Prescribed steroids with diabetes

Elevated glucose levels are a well-documented side effect of systemic steroids (hyperglycemia). As you are well aware, this can be particularly difficult for people who have diabetes. Insulin is the most effective medication for treating hyperglycemia caused by steroids. During their stay in the hospital, patients can receive steroids through the IV route (intravenous). The doses given intravenously are frequently much higher than those given orally. For hyperglycemia patients admitted to the hospital, medical providers may prescribe a variety of insulin regimens that must be administered at various times throughout the day. Taking steroid pills at home may not necessitate starting any new insulin, but you can consult your healthcare provider for advice on the appropriate dose to use with your current insulin if you have diabetes.

Some steroids, such as prednisone, have been shown to temporarily raise blood glucose levels for a period of time during the day. When prednisone is taken only once per day, such as in the morning, this will be the most noticeable side effect. The morning prednisone pill may cause your glucose level to be the same as it usually is before you take the morning pill. Later in the day, on the other hand, your glucose level could be significantly higher. This is due to the fact that steroids increase insulin resistance, which causes your body’s own insulin or injected insulin to perform less effectively. Some people are particularly concerned about what they eat because they believe it is the food that is causing the unusually high glucose readings, but the steroid is most likely to blame for the elevated glucose levels.

Is there anything I should be aware of while taking steroids?

If you are using an insulin pump, you may be able to increase your basal rate slightly for a portion of the day if necessary. This can be accomplished through the use of a temporary basal rate. Alternatively, if you are using the MiniMed 670G system, inquire with your provider about the possibility of switching to Manual Mode during your course of treatment with the steroid. If you have diabetes, monitoring your glucose levels with a continuous glucose monitor (CGM) such as the Guardian Connect system or MiniMed insulin pump systems is one of the most effective ways to determine if you require a higher basal rate.

Make a note of how many days you intend to use the anabolic steroid. The long-term consequences of hyperglycemia are unknown if you only take the steroid for a few days. The following are the short-term consequences of high glucose: dehydration, diabetic ketoacidosis (DKA), and kidney failure.

Make sure to drink plenty of water and sugar-free beverages to stay hydrated.

Check your blood glucose levels several times a day, or as directed by your healthcare team, to ensure that you are healthy.

Following recommendations from the American Diabetes Association, experts recommend checking for ketones every 4-6 hours if your glucose level is greater than 240 mg/dL. In the event that you have ketones in your urine, notify your healthcare provider immediately, especially if the level is moderate or higher.

Consult with your healthcare provider about your insulin dosage and always follow their recommendations. You should not increase your insulin dose while taking steroids; instead, you should reduce your insulin dose to its normal level once the steroids have been discontinued.

If your healthcare provider recommends that you stop taking your steroid medication early, follow his or her advice.

See also The Effects of Steroids on Cholesterol

Prednisone

Prednisone is a steroid that functions in a manner similar to cortisol, which is a hormone that the adrenal glands normally produce in response to stressful situations. Steroids have the potential to alter the way the body responds to insulin, a hormone that regulates the amount of sugar in the blood.

As a result, people who are at risk of developing diabetes or who already have the disease should exercise caution when taking steroids.

Medications such as steroids are used to treat a wide range of conditions, including autoimmune disorders and conditions involving inflammation, such as arthritis, among others. They work by reducing immune activity and inflammation, which allows them to help prevent tissue damage and other complications.

The relationship between steroids and blood sugar levels

As a result of making the liver more resistant to insulin, prednisone and other steroids can cause a spike in blood sugar levels. The pancreas is responsible for the production of insulin, which helps to regulate blood sugar levels.

Type 2 diabetes can occur as a result of a problem with the way the body responds to insulin or as a result of a problem with the production of insulin in the pancreas.

Insulin is produced by the pancreas and transported to the liver when blood sugar levels are elevated.

Insulin’s arrival at the liver results in a reduction in the amount of sugar that this organ normally releases to fuel the cells’ energy requirements. Sugar, on the other hand, enters the cells directly from the bloodstream. This procedure lowers the overall concentration of glucose in the blood.

Due to the fact that steroids cause the liver to continue releasing sugar even when insulin is being released by the pancreas, steroids can cause the liver to become less sensitive to insulin. The pancreas is triggered to stop producing the hormone as a result of the continued release of sugar.

If this process is allowed to continue, insulin resistance will result. Insulin no longer has any effect on the cells, regardless of whether the insulin is produced by the body or whether it is administered intravenously to control diabetes.

Steroid-induced diabetes is the term used by doctors to describe this condition.

Diabetes caused by steroid use

Diabetes caused by steroid use

It is similar to type 2 diabetes in that the cells fail to respond appropriately to insulin when the body is exposed to steroids.

Diabetes is a medical condition in which blood sugar levels remain consistently high. Typically, two types of diabetes develop: type 1 and type 2.

Type 1 diabetes is characterized by the absence of insulin production by the pancreas.

Type 2 diabetes is characterized by the failure of the pancreas to produce enough insulin or the failure of the cells to respond to the insulin that is circulated in the body.

If you have been diagnosed with steroid-induced diabetes, it is important to seek medical attention as soon as possible. Unlike type 1 and type 2 diabetes, which are chronic conditions that require ongoing management, type 1 and type 2 diabetes are not.

Causes

As a general rule, when your blood sugar level is elevated, your pancreas produces insulin, which is then transported to your liver. As a result, less sugar is released into the bloodstream.

Steroids can make your liver less sensitive to insulin, which can lead to diabetes. Consequently, even though insulin is being delivered to the liver, the liver continues to release sugar into the bloodstream. The continued production of sugar signals to your pancreas that it should cease insulin production.

In addition, steroids act as a cortisol substitute. Known as the stress hormone, cortisol is produced by the adrenal glands and is associated with the body’s response to stress. When you are stressed, your body releases higher levels of cortisol into the bloodstream. Your fat and muscle cells become less sensitive to insulin as a result of the elevated cortisol levels. For diabetics, this means that you may need to take more medication or insulin in order to keep your blood sugar levels within a normal range of values.

Insulin resistance can develop as a result of prolonged steroid use. This occurs when the cells no longer respond to insulin, causing your blood sugar levels to rise to the point where you are diagnosed with diabetes. This is referred to as steroid-induced diabetes.

It is not always possible to avoid taking steroids. Steroids are used to treat a wide range of conditions by reducing inflammation in the body.

If you are taking steroids, it is critical to be aware of the precautions you can take to reduce the likelihood of experiencing negative side effects. In order to accomplish this, you should keep a close eye on your symptoms and only use steroids for a short period of time if at all possible.

Symptoms

The symptoms of steroid-induced diabetes are similar to those of type 1 diabetes, type 2 diabetes, and gestational diabetes, among other conditions. It is possible that symptoms of steroid-induced diabetes will not manifest themselves until blood sugar levels have risen significantly.

Some of the signs and symptoms of steroid-induced diabetes are as follows:

  • increased thirst
  • tiredness or lethargy
  • unintentional weight loss
  • dry mouth
  • dry or itchy skin
  • nausea with or without vomiting
  • frequent urination
  • blurred vision

Treatments

There is currently no best way to treat steroid-induced diabetes that is widely accepted by the scientific community at this time.

Having your health and potential for high blood sugar (hyperglycemia) and insulin resistance evaluated by a healthcare professional is critical before deciding on a treatment plan. It is also important to keep track of how much, what kind, and how often you are taking steroids.

Some people with steroid-induced diabetes may be able to control their condition with diet and physical activity alone, but others may require oral diabetes medications or insulin.

The first step in treating you will be determined by the number of steroids you are taking and your blood sugar levels. Insulin, metformin, and sulfonylureas are among the medications that can be prescribed.

All people with diabetes, as well as those who are at high risk of developing steroid-induced diabetes, should have access to blood glucose monitoring in order to help prevent high blood sugar emergencies from occurring.

During the course of lowering the steroid dose, it is also important to reduce the dosage of diabetes medications or insulin to an appropriate level as well. It is recommended that you see a healthcare professional to evaluate your diabetes status and to ensure that your blood glucose levels are where they should be.

If your steroid treatment is interfering with your blood sugar levels, talk to your doctor about stopping it.

As with other types of diabetes, a person who has steroid-induced diabetes should make changes to their lifestyle in order to improve their blood glucose management.

Consuming a nutritious, well-balanced diet and engaging in regular physical activity are examples of lifestyle changes.

Blood sugar levels typically spike within 1–2 days of beginning the course of treatment when steroids are the cause of diabetes in question. A person who takes steroids in the morning will typically see an increase in blood sugar levels by the afternoon or evening.

If your blood sugar levels rise too high while taking steroids, you may need to take oral medication or insulin to bring them back down to a healthy level.

According to general guidelines, blood sugar levels should return to their pre-treatment levels 1–2 days after the end of steroid treatment. Some people, however, may develop type 2 diabetes as a result of the procedure and will require appropriate follow-up treatment, which may include oral medications or insulin therapy.

The significance of one’s way of life

When it comes to managing diabetes, including steroid-induced diabetes, one’s way of life is extremely important.

It is possible to improve blood sugar management by following a healthy and balanced diet and engaging in regular physical activity. It is also possible that working with a dietitian will help you manage blood sugar spikes after meals.

Despite the fact that exercise can help you manage your blood sugar, you should consult with your doctor before beginning any exercise program to ensure that it is safe for you and will not interfere with any existing health conditions.

Factors that increase risk

It is those who take high doses of steroids for long periods of time who are most at risk of developing type 2 diabetes caused by steroids.

The following are additional risk factors for type 2 diabetes:

  • Being aged 45 years or older
  • Being overweight
  • A family history of type 2 diabetes
  • A personal history of gestational diabetes
  • Impaired glucose tolerance

Taking steroids with diabetes

Prednisone and other steroid medications will be unavoidable for people who have certain medical conditions. Even if a person has diabetes, these medications can help them have the best chance of recovering or getting relief from their pain.

Prednisone or a similar medication will not be effective unless the following steps are taken by people with diabetes before starting the medication:

Inform the doctor of the patient’s diagnosis of diabetes. It is possible that the doctor will be able to prescribe a different medication that will not interfere with blood sugar levels in some cases.

If this is not possible, they will most likely have to make adjustments to the prescribed dosage in order to keep blood sugar levels within the target range of the patient.

Increase the frequency with which you check your blood glucose levels. This should be done four or more times per day, according to the experts.

Depending on your blood sugar levels and whether or not your doctor recommends it, you may need to increase your insulin or oral medication dosage.

Ketone levels should be checked in the urine or blood.

In the event that your blood sugar levels rise too high while taking steroids and your insulin or oral medication dose is not high enough to bring them back down, consult your doctor immediately.

Carry glucose tablets, juice, or candy with you at all times in case your blood sugar levels plummet unexpectedly.

As a person gradually reduces their steroid dosage, they should also gradually reduce the equivalent dosage of insulin or oral medication until the dosage is returned to its original level, if possible. If you stop taking steroids suddenly, you run the risk of suffering from a life-threatening condition.

See also A Guide to Safe Steroid Stacking

Interactions between medications

People with diabetes frequently require medication for a variety of other conditions. If a person is taking insulin at the same time as taking any medication, the risk of experiencing harmful drug interactions increases significantly.

Oral hypoglycemics are the most commonly prescribed diabetes medications for people who have diabetes.

These medications are as follows:

  • thiazolidinediones, such as rosiglitazone (Avandia)
  • alpha-glucosidase inhibitors, such as acarbose (Glucobay, Precose)
  • biguanides, such as metformin (Glucophage)
  • sulfonylureas, such as glyburide (Micronase, DiaBeta)
  • meglitinides, such as repaglinide (Prandin)

These medications have the potential to interact with each other as well as with other medications. If you are taking sulfonylureas, metformin, or thiazolidinediones, you should exercise extra caution, especially if you are taking them to treat any of the conditions listed below:

  • Liver ailment
  • Cardiovascular disease
  • Kidney disease

If a patient’s steroid-induced diabetes does not respond to lifestyle changes or oral medications, doctors may recommend insulin therapy as part of their treatment plan for the condition.

There are numerous medications that interact with insulin, including:

  • ACE inhibitors
  • aspirin
  • beta-blockers
  • steroids
  • estrogens
  • hypothyroid drugs
  • monoamine oxidase inhibitors (MAOIs)
  • niacin
  • oral contraceptives
  • sulfa antibiotics

People who have diabetes should always discuss possible drug interactions with their doctor.

People with diabetes who have other conditions such as asthma, arthritis, autoimmune diseases, and dermatitis or who are undergoing chemotherapy may need to take steroid medications to help manage those conditions as well as their diabetes.

Steroid medications are used to alleviate pain and inflammation, and they can also be used to prevent nausea during medical procedures such as surgical procedures (such as chemotherapy).

When you are stressed, injured, or ill, your body produces steroid hormones (also known as corticosteroids) to aid in the fight against disease and injury. The effects of steroid medications are similar to those of hormones produced by the human body. There are many different types of steroid medications available, including cortisone, hydrocortisone, prednisolone, prednisone, and dexamethasone, to name a few examples.

Steroid medications can be administered in a number of different ways, including:

  • Orally by mouth (as tablets or liquid)
  • With the aid of an inhaler
  • Through the use of injection (into a joint, vein, or muscle)
  • In the form of drops for the eyes or ears
  • As a cream that is applied topically to the skin

What is the relationship between steroid medications and blood glucose levels?

Steroid medications and blood glucose

If you have diabetes and are taking steroid medication, it is likely that your blood glucose levels will rise. Steroid medications have the potential to raise blood glucose levels by impairing the action of insulin (causing insulin resistance) and causing the liver to release glucose stored in the liver into the bloodstream, among other mechanisms.

The length of time it takes for these medications to begin to have an effect on your blood glucose levels can vary depending on how you are administering them to yourself.

The use of oral steroids may result in an increase in blood glucose levels within a few days of starting the medication. The effect of steroids on blood glucose levels will vary depending on the time of day, the dose, and the type of steroid being used.

Following steroid injections, blood glucose levels may spike immediately after the injection and may remain elevated for 3-10 days following the injection.

Medications used to treat skin conditions, as well as inhaled steroids used to treat asthma, as well as ear and eye drops, are unlikely to have an impact on blood glucose levels.

You should speak with your doctor about how taking steroid medication may affect your blood glucose levels and seek advice on how to manage this. Please ask your doctor or pharmacist for a patient information sheet regarding this medication.

High blood glucose levels can make you feel ill, tired, or depleted of energy, as well as thirsty and dehydrated. It may also cause you to pass urine more frequently.

Consult with your doctor or a credentialed diabetes educator for guidance on how to monitor your blood glucose levels while taking steroid medication.

In the event that you are taking steroid medication, speak with your doctor about the potential impact on your blood glucose levels.

What you should know before beginning steroid therapy

Keep in mind that you have diabetes and tell your doctor. Your doctor may decide to reduce the dose of your steroid medication in order to reduce the risk of side effects.

Please make certain that you understand how to safely take oral steroid medication.

Because steroid medications can cause blood glucose levels to rise, speak with your doctor or a credentialed diabetes educator about having your levels checked more frequently. If your blood glucose levels are consistently above the target range, consult with them for advice on how to manage your diabetes.

As a result of your use of steroid medication, consult with your doctor or a credentialed diabetes educator to determine whether your diabetes medication or insulin dosage needs to be adjusted.

Continually adhere to a nutritious eating plan and engage in regular physical activity.

If you are receiving long-term steroid treatment, it is recommended that you wear some form of identification, such as a Medic Alert bracelet.

The use of oral steroid medications should not be abruptly discontinued if you have been taking them for a long time. Your doctor will provide you with specific instructions on how to gradually discontinue your medication.

Summary

It is true that taking steroids has risks and side effects, just like any other medication. Steroid-induced diabetes, for example, is one of the risks that can occur.

However, it is important to be aware of the possibility of steroid-induced diabetes, especially if you are using steroids for an extended period of time.

Usually, steroid-induced diabetes subsides after the course of steroids is completed, but it can occasionally progress to type 2 diabetes, particularly in those who use steroids for an extended period of time (e.g., bodybuilders).

Discuss the use of steroids with your doctor if you are at risk of developing type 2 diabetes in the future. Your doctor can assist you in making informed and appropriate decisions, as well as provide ongoing monitoring to help you stay healthy and reduce risks to yourself and those around you.

See also Prednisolone for Fertility Treatment

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