Diabetes and steroids

Monday, 17 September 2018

If your doctor prescribes corticosteroids (steroids) you may notice your blood glucose levels (BGLs) begin to rise, this is because steroids increase insulin resistance.

Steroids are medications that contain synthetic versions of cortisol. Cortisol is the hormone produced by our adrenal glands and is responsible for our body’s stress response.

Steroids may be taken in tablet form, through inhalers, via injections or through lotions, gels and creams applied to your skin. These are called systemic steroids, they vary in strength and can be used for short term treatment or for longer, sometimes indefinitely.

Some examples of steroids your doctor might prescribe for you are Prednisolone (Prednisone) Dexamethasone, Methylprednisolone and Hydrocortisone. It’s important not to confuse the steroids your doctor prescribes for you with anabolic steroids body builders use to build muscle.

Inhaled steroids used for asthma won’t affect your BGL, but an injection of steroid into your joint or muscle can cause a rise in your levels soon afterwards, and may affect your levels for up to a week. If you are taking steroids in tablet form (such as Prednisolone (Prednisone) Dexamethasone, Methylprednisolone and Hydrocortisone) or through lotions, gels and creams applied to your skin you may see changes within days rather than hours.

It’s important to try and maintain normal glucose levels to prevent you from feeling tired and lethargic, and to lower your risk of other things like urinary tract infections, thrush, DKA if you have type 1 diabetes, hyperglycaemic hyperosmolar state if you have type 2 diabetes, and long term complications.

While you are taking steroids you are encouraged to check your BGL more often to identify patterns, this way your medications can be changed or adjusted to what your needs are. Sometimes people need insulin while they are taking steroids but stop the insulin when they don’t need steroids any more.

Try and stick to your regular exercise routine and healthy eating plan, this will not only help manage your numbers, it will also make you feel good. Sometimes if you are on steroids long term you may need calcium and vitamin D supplements. Check with your doctor before starting supplements and keep in contact with your diabetes team for ongoing support and education.

Apart from high blood glucose levels there can be other unwanted side effects from steroids, however if your GP has prescribed steroids it is with the belief that it is the most appropriate treatment for you. Talk to your doctor about what you may expect when you start taking steroids.

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