Understanding Steroids and Diabetes
Steroids are used to treat various conditions where there is inflammation in the body. They work by reducing this inflammation. Some examples of the conditions they are used to treat are:
- Rheumatoid arthritis
- Asthma
- Inflammation of the bowel
- Some types of malignant diseases
- A few other auto-immune conditions
There are many different types of steroids. Some of the more common steroid drugs include:
- Prednisolone
- Hydrocortisone
- Betamethasone
- Dexamethesone
- Deflazacort
If you do not currently have diabetes
Some people taking steroids experience side-effects. These can include an increase in your blood glucose levels caused by a lack of insulin in your body.
Insulin is a hormone produced by the pancreas that helps the glucose enter the cells where it is used as fuel for the body. The reason that blood glucose levels rise during steroid treatment is that the liver produces more sugar than normal and your body is not able to produce enough insulin to cope with this increase. In addition, the insulin produced may not be working properly in your body; this is known as ‘insulin resistance’.
If you are taking steroids, you will need to have your blood glucose levels checked regularly. Your doctor or clinic nurse will be able to do this for you. If you are concerned that you may be developing diabetes while you are on steroids, contact your doctor or local diabetes clinic.
Your blood glucose level may rise 24–48 hours after your first steroid injection or first dose of tablets, although this may be temporary. Inhaled steroids and steroid skin creams are unlikely to increase your blood glucose levels.
If you are prescribed steroid pills on a frequent basis or in large doses, then the risk of developing diabetes increases. This risk is further increased if you have a family history of diabetes or if you developed diabetes during pregnancy (gestational diabetes).
If your steroid treatment is intermittent, e.g. if you only take medication with an acute recurrence of your illness, your diabetes treatment may need to be intermittent too. This means that in between courses of steroid therapy, you may not need to take tablets or insulin. Once you start taking steroids again, however, you may also need to restart diabetes treatment.
If you have been on large doses of steroids but these doses are reduced as you get better, then treatment for your diabetes will also need to be reduced or you will be at risk of hypoglycaemia (low blood glucose).
You may need to take steroids on a permanent basis. If you do, and you have developed diabetes, you will be reviewed by your doctor or may be asked to attend the diabetic clinic at the local hospital.
If you already have diabetes
If you have diabetes and you are prescribed steroids, then you may notice a rise in your blood glucose levels, which will usually mean that your diabetes treatment needs to be adjusted. It is important that you check your blood glucose levels regularly. If you are concerned that your diabetes is getting out of control while you are on steroids, contact your diabetes care team.
Your blood glucose level may rise 24–48 hours after your first steroid injection or first dose of tablets, although this may be temporary. Inhaled steroids and steroid skin creams are unlikely to increase your blood glucose levels.
If your steroid treatment is intermittent, e.g. if you only take it with an acute recurrence of your illness, you may need to be on a different diabetes treatment while you are taking steroids.
If you have been on large doses of steroids but these doses are reduced as you get better, then treatment for your diabetes will also need to be reduced or you will be at risk of hypoglycaemia (low blood glucose).
You may need to take steroids on a permanent basis. If so you will be reviewed by your doctor or may be asked to attend the diabetic clinic at the local hospital.
