How Do I Control My Blood Sugar (Diabetes) while on steroids: Guide

Steroids are a class of manufactured anti-inflammatory drugs that are used to treat a variety of complications, especially when the immune system breaks down causing tissue damage. While steroids benefit by minimizing the tissue damage, they have immense side effects. Very often people ask questions like how do i control my blood sugar while on steroids, does prednisone raise blood sugar, etc. These drugs need to be taken with utmost caution and with proper prescription from a registered medical practitioner.

Steroids are known to cause steroid-induced diabetes in non-diabetics. Also, diabetic patients can have increased glucose levels, while they are on steroids.  Steroids suppress the insulin effect causing insulin deficiency and the liver starts pushing the stored glucose into the bloodstream leading to increased blood sugar levels. This sequence of actions can cause obstinate diabetes and can be difficult to manage. 

This article provides you with an insight into the effect of steroids on your blood sugar levels and guide to control your blood sugar level while on steroids & give you an answer on How Do I Control My Blood Sugar while on steroids.

Table of Contents:

Feel free to skip ahead if one topic catches your eye:

  1. Steroids and diabetes
  2. Why do steroids increase blood sugar?
  3. Do all steroids raise blood sugar?
  4. How do i control my blood sugar while on steroids?
  5. How long will steroids affect blood sugar?
  6. How do you reverse steroid-induced diabetes?
  7. Do steroids raise blood sugar in non-diabetics?
  8. Steroid-induced diabetes guidelines by NHS?
  9. FAQ’s

Take Away

1. Steroids and diabetes 

A man-made anti-inflammatory drug that mimics a naturally occurring hormone produced in the adrenal cortex of the adrenal glands is corticosteroids or commonly termed steroids.  These drugs are used in the treatment of a variety of conditions like arthritis, influenza, asthma, vasculitis and even Covid 19. They are considered to save organs, tissues and even life in many instances. 

When the body’s natural defence mechanism does not function properly or is overactive, the body is prone to inflammation and tissue damage. This is when the steroids act upon to reduce the production of inflammation-causing agents and minimize tissue damage. For instance, in cases of patients having lupus or vasculitis, kidney inflammation or kidney failure can be averted with the help of steroids. 

On one hand, the steroids significantly reduce tissue damage, on the other hand, they lead to insulin intolerance causing steroid-induced diabetes even in non-diabetic patients. The diabetic condition caused can eventually decrease with the decrease in steroid intake. However, in a few, this steroid-induced diabetic condition can lead to the risk of developing type 2 diabetes. 

While we have understood the effect of steroids in non-diabetic patients, in people living with diabetes, the effect is more severe as the pancreas does not function up to the mark and insulin production is hampered. In a diabetic patient, to overcome the dearth of insulin, insulin shots are taken to stimulate insulin production. However, when steroids are in action, the insulin activity is curbed by the liver causing insulin resistance. While the insulin activity is suppressed, the liver allows the passage of reserved glucose into the bloodstream. This increases the blood sugar levels causing a condition called steroid-induced hyperglycemia. The main reason why one should avoid steroids even if you are diabetic or non-diabetic.

The effect of the steroids on the blood sugar levels in preexisting diabetic conditions will depend on :

  1. The type of diabetes one has
  2. Amount and dosage of steroids
  3. Duration of steroid intake 

It is always recommended to take these corticosteroids under the diabetes specialist doctor’s vigilance and prescription. It is extremely important to control your diabetes while on steroids.

Use of steroids for Covid treatment 

SARSCov2 can stimulate a systemic inflammatory response that can cause lung damage and multi-organ dysfunction. In a few cases, rational use of corticosteroids in covid 19 patients can benefit by reducing inflammatory responses, tissue or organ damage and risk of death. However, In patients with severe Covid 19, early use of steroids, or even an overdose of steroids helped to replicate the viral activity and further aggravate the conditions. The recent study and analysis have proven that high doses of steroids in mild cases of covid can lead to pneumonia and black fungus or mucormycosis. An added effect of steroids on your blood glucose levels can worsen the complications in covid patients with diabetes.

2. Why do steroids increase blood sugar?

While you take steroids, the liver tends to produce more sugar in the body, and the excess sugar produced gets accumulated in the blood, causing a rise in blood sugar levels. The steroids also make the liver cells resistant to insulin, causing insulin resistance that manifests in less insulin uptake and excess blood sugar levels.

3. Do all steroids raise blood sugar?

Steroids are highly beneficial and pain-relieving medications that lessen further tissue damage. But, one of the major side effects of steroids is that they tend to raise the blood sugar level while you administer them. However, this rise in blood sugar levels in the body is temporary and mostly occurs in a diabetic or pre-diabetic condition. In some cases, steroids can also affect non-diabetic people.

steroids & diabetes

4. How Do I Control My Blood Sugar While On Steroids?

Steroids are known to increase blood glucose levels and so one should avoid steroids whenever possible. But, certain therapies like chemotherapy and certain critical conditions demand the need of steroids therapy. While it is unavoidable to take these drugs in some cases, you can manage to control your blood sugar levels while on steroids in the following ways :

  • Let your doctor be informed about the pre-diabetic condition, this could help prescribe different medications that do not interfere with blood glucose levels.
  • Adjust the blood-glucose-lowering medications according to the timing, dosage of the steroids and its response observed in an individual.
  • Constant checking of your blood sugar level is advised. 
  • Your Diabetes specialist may advise an increase in your insulin intake depending on the blood glucose levels.
  • Regular monitoring of urine and blood ketones is important to avoid severe complications.
  • It is crucial to consult your doctor if the blood glucose levels are not getting stable despite an increase in insulin and oral medications.
  • Maintain a healthy diet with low sugar intake with foods that help control your blood sugar levels while on steroids.
  • Sometimes, the blood glucose levels can drop significantly, it is always advised to carry the juice, glucose tablets, a bar of chocolate, etc.

It’s important to note that, it’s not recommended to stop taking steroids all of a sudden. It is also required to lower your insulin intake along with the reduction of steroids dosage. This can be best guided by your diabetes specialist who would help control your diabetes while on steroids

5. How long will steroids affect blood sugar?

Long-term use of steroids can lead to transient resistance to insulin where the cells cannot uptake the insulin produced. Thus, increasing the blood glucose levels in the body. Generally, blood glucose levels return to their baseline levels within 1–2 days of steroid treatment. However, sometimes, people may develop type 2 diabetes or steroid-induced diabetes that will require appropriate treatment, regular monitoring, and additional insulin intake.  

6. How do you reverse steroid-induced diabetes?

Diabetes induced due to steroid intake is treatable and can be reversed. Steroid-induced diabetes goes away a day or two after the steroid intake is stopped. 

If you are worried about- “How do I control my blood sugar while on steroids,” you need to have a healthy routine with proper diet, exercise, insulin therapy, regular blood glucose monitoring, and timely medication intake are some ways that can help treat diabetes during steroid administration. Certain studies also suggest that chromium supplementation can help reverse corticosteroid-induced diabetes. 

Get connected with a diabetes specialist to get the right treatment and management solution to reverse steroid-induced diabetes.

7. Do steroids raise blood sugar in non-diabetics?

Steroids affect how liver cells act towards insulin, so steroids spike the blood sugar levels even in a non-diabetic person. In some, the effect may be temporary, but in others, this effect can permanently lead to type 2 diabetes, especially when taken for a long term. 

8. Steroid-induced diabetes guidelines by NHS?

According to the National Health Services, UK, guidelines for managing steroid-induced diabetes are as follows.

  • Steroid-induced diabetes must be treated with insulin injections and medications. 
  • Regular monitoring of blood glucose concentrations is a must.
  • Diabetes specialists will adjust the insulin dose if needed, depending on the regular testing and glucose monitoring results. 
  • The patient needs to be well-informed on managing diabetes and steroid-induced diabetes with proper diet and exercise.

9. FAQ’s

1. Can steroids increase hba1c?

Steroids, in a way, affect the blood sugar levels, but less do we know how it affects Hba1c. Studies show how the overall or total dose of steroids predicts an increase in HbA1c levels. According to studies, not all steroids affect Hba1c. However, certain steroids like prednisone are proven to increase Hba1c when used long-term. 

2. How long does prednisone affect blood sugar?

The pancreas produces the insulin hormone to help convert sugar or glucose into energy. When insulin is inadequately generated by the pancreas or less efficiently absorbed by the liver cells, the blood sugar levels spike up due to the non-conversion of glucose to energy. Nevertheless, for questions like “Does prednisone raise blood sugar?” Prednisone can increase the glucose level for a part of the day from its administration time. 

3. Does steroid-induced diabetes go away?

Yes, steroid-induced diabetes can go away. Steroids temporarily cause hyperglycemia that lasts for nearly 24 hours of steroid administration. However, long-term use of steroids can lead to type-2 diabetes in people with pre-diabetic conditions. 

4. Is prednisone-induced diabetes reversible?

Like other steroids, prednisone and blood sugar go hand in hand. Prednisone is known to bring about a blood sugar spike by making the liver cells resistant to insulin. The diabetes effect of prednisone is usually transient and reversible. But, long-term use of steroids can trigger the onset of type-2 diabetes in a few. 

Take Away-

Steroids can act as a friendly foe. Well calculated use of steroids in treating inflammation and tissue damage cannot be overruled consecutively, its effects of systematically increasing the blood sugar levels in both non-diabetic and diabetic patients cannot be undervalued. While in non-diabetic patients, the pancreas works extra to stabilize the sugar levels, whereas, in diabetic patients, there are certain means to modulate the blood glucose levels accordingly. 

Consulting Dr. Hemi Soneja, the diabetes doctor who would check the need, timing and dosage of steroids and also review your insulin intake accordingly. At Hemi soneja Clinic, you will get the right suggestions on how to control your blood sugar levels while on steroids.

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