Irl Diabetes And Steroids Stories
The obvious caveat to all of this is that , individual diabetes experiences may vary.
When DiabetesMine reached out to the diabetes online community on this topic, dozens replied saying theyd experienced huge jumps in blood sugar after using various types of steroids.
Laura Higgins of Utah, whos lived with T1D for almost two decades since age 13, says shes seen big BG spikes after being on steroids several times through the years. But she knew the risks and worked with her diabetes education and care specialist to best manage those fluctuations.
Her partner had a different story, however. He was diagnosed with type 2 diabetes a couple of years before they started dating, and earlier this year an urgent care doctor prescribed steroids for bronchitis, without even inquiring or looking at his chart, and not explaining the blood-sugar risks and potential for diabetes ketoacidosis .
By this time I had coached him into how to manage his diabetes and he was testing with all these crazy numbers over 400 mg/dL, she says. She noted that with her backup Novolog insulin pen she had taught him to use, her husband was dosing 30+ units to bring his numbers down to more manageable levels.
He finished the steroids and I got him in with the primary care doctor that my manages my type 1 because I was so appalled at the negligence, she tells DiabetesMine.
Others echoing similar experiences preferred to have their names withheld:
Steroid Medications And Diabetes Fact Sheet
This fact sheet is available in two formats.
You can download and print out the PDF version.
Or you can read it as a website page below.
Some people with diabetes may need to take steroid medications to help manage other conditions, such as asthma, arthritis, autoimmune diseases and dermatitis, or as part of chemotherapy.
Steroid medications reduce pain and inflammation, and they can also be used to prevent nausea during medical procedures .
Your body produces steroid hormones to help it fight stress, injury and disease. Steroid medications have a similar effect to the hormones produced by the body. There are many different types of steroid medications, including cortisone, hydrocortisone, prednisolone, prednisone and dexamethasone.
Steroid medications can be taken in various ways, including:
- with an inhaler
- as drops for eyes or ears
- as a cream applied to the skin.
How Steroids Affect Your Blood Sugar
Corticosteroids, or steroids for short, are a common medication prescribed for a multitude of ailments, but can often cause blood sugar issues for people living with diabetes.
If youve ever been prescribed a steroid, you may know that they spike blood sugars easily and quickly, and can lead to stubborn hyperglycemia for days on end.
In this article, I will describe exactly how steroids affect blood sugar and what you can do about it.
At the end of the article, I will also describe the rare situation where steroid therapy may actually cause type 2 diabetes by triggering a complication called steroid-induced diabetes.
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Deflazacort Vs Prednisone Effect On Blood Glucose Control In Insulin
Deflazacort vs prednisone. Effect on blood glucose control in insulin-treated diabetics. Bruno A , Cavallo-Perin P , Cassader M , Pagano G . Glucocorticoid treatment produces a deterioration of blood glucose control in diabetics. Recent reports have indicated that deflazacort is less diabetogenic than prednisone in healthy subjects. Ten insulin-treated diabetics who required steroid drugs were treated with deflazacort and prednisone in randomized, double-blind design after a pretreatment period of four weeks. At the end of each treatment, plasma glucose profile , hemoglobin A1 level, and insulin requirements were compared. Mean plasma glucose level and hemoglobin A1 values were significantly lower after deflazacort than after prednisone. Also, insulin requirement was significantly lower after deflazacort than after prednisone . These results indicate that deflazacort, when employed in an anti-inflammatory dose equivalent to prednisone, should prove advantageous in insulin-treated diabetics who require steroid treatment.Continue reading > >
- The effect of a low-carbohydrate, ketogenic diet versus a low-glycemic index diet on glycemic control in type 2 diabetes mellitus
How Do Cortisone Shots Work
Doctors give cortisone shots during an office visit directly into the area or joint involved, or sometimes just into a large muscle to get it into the bloodstream. In other parts of the body, the injection often includes a local anesthetic to start easing pain immediately. In these cases, cortisone is typically injected into three areas:
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Taking Steroids With Diabetes
For people with certain conditions, taking prednisone and other steroids will be unavoidable. These medicines can give a person the best chance of recovery or pain relief, even if they also have diabetes.
People with diabetes will need to take the following steps before starting a course of prednisone or a similar medication:
Make the doctor aware of their diabetes diagnosis. The doctor may sometimes be able to prescribe a different drug that does not interfere with blood sugar levels.
If this is not possible, they will often need to make adjustments to the prescribed dosage to keep blood sugar levels within the target range.
- Check blood glucose levels more often than usual. Experts recommend doing this four or more times a day.
- Increase the dosage of insulin or oral medication, depending on blood sugar levels and whether a doctor advises it.
- Monitor urine or blood ketones.
- See a doctor immediately if blood sugar levels rise too high while taking steroids, and the insulin or oral medication dose is not high enough to bring the levels down.
- Carry glucose tablets, juice, or candy at all times in case blood sugar levels drop suddenly.
As a person gradually reduces their dosage of steroids, they should also reduce the equivalent dosage of insulin or oral medication until it returns to the original dosage. It is important never to stop taking steroids suddenly as this may cause severe illness.
of the person experiencing harmful drug interactions if they are also taking insulin.
Tips For Diabetes Management While On Steroids
Both Scheiner and Bell say they find it surprising how few PWDs actually know about these steroid effects on glucose levels and how many healthcare professionals dont explain the likely effects to someone with diabetes before giving a steroid injection or prescription.
The advice that PWDs who might be taking steroids should be getting is pretty clear, per this Medical News Today report:
- Check blood glucose levels more often than usual. Experts recommend doing this four or more times a day.
- Work with your doctor to increase the dosage of insulin or oral D-medication, depending on blood sugar levels and other health considerations.
- Monitor urine or blood ketones to be sure BG levels arent approaching dangerously high.
- See a doctor immediately if BG levels do rise too high while taking steroids, and increased insulin or oral medication doses do not bring the levels down.
- As a person gradually reduces their dosage of steroids, they should also reduce the equivalent dosage of insulin or oral medication until it returns to the original dosage. It is important never to stop taking steroids suddenly, as this may cause severe illness.
- Carry glucose tablets, juice, or candy at all times, in case blood sugar levels drop suddenly from the additional D-medication being taken.
In addition to that textbook advice, Scheiner adds some practical tips:
Bell says dealing with these steroid-related BG rises usually means increasing short-acting insulin and/or insulin pump basal rates.
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How To Treat Prednisone
People who are using prednisone to treat certain medical conditions should talk to their doctors about alternative treatments that will not spike blood sugar or increase the risk for type 2 diabetes. In some cases, doctors may prescribe different medications or recommend healthy lifestyle changes that could improve their conditions.
Those who must continue using prednisone should monitor their blood sugar levels regularly and work with their doctors to prevent or control diabetes. People who are already diagnosed with type 2 diabetes should check their blood sugar levels at least four times per day and use higher doses of insulin as advised by their doctors. These individuals should also keep glucose tablets, juice or candies with them at all times to treat hypoglycemia in the event that blood sugar levels should drop abruptly.
Does Insulin Lower Iop
The relationship between diabetes and glaucoma is incompletely characterized. In some but not all studies, diabetes has been shown to be a risk factor for glaucoma, but in the Ocular Hypertension Treatment Study, diabetes was found to be a protective factor that reduced the risk of developing glaucoma among subjects with elevated IOP.
A research team led by Muhammad Abdulrazik, M.D., Al-Quds University, Jerusalem, investigated the intriguing hypothesis that initiating insulin therapy in diabetic patients results in a clinically significant reduction in IOP.
Although previous studies have shown that insulin therapy appears to have no effect on IOP, unexpected IOP findings from follow-up of patients initiating insulin therapy have justified a reassessment, Dr. Abdulrazik said.
They evaluated a series of 21 subjects with type 2 diabetes scheduled to begin therapy with subcutaneous insulin. IOP was measured on several occasions over a three-week period before the initiation of therapy and again several times after three months of insulin therapy.
Statistically significant changes in IOP from baseline were observed in patients after the third month of insulin therapy, said Dr. Abdulrazik. Interestingly, the IOP-lowering effect of insulin was inversely related to body mass index .
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What To Do When You Start Steroid Therapy
If you need to take steroids for any ailment, tell your prescribing physician that you have insulin-dependent diabetes. Speak with your doctor for any advice they may have for controlling your blood sugars while on steroid medication.
Its helpful to also ask for an information sheet about the medication youre taking, to learn more.
Some other strategies to manage steroid therapy with diabetes include:
- Speak with your prescribing physician about whether your insulin needs to be adjusted while you are on steroids
- Check your blood sugar more often than usual
- Closely monitor for ketones. Any blood sugar over 250 mg/dL with moderate to high ketones will require a call to your doctor or visit with your urgent care clinic
- If youre experiencing signs and symptoms of DKA, seek immediate medical care or call 911
- Carry extra low blood sugar snacks with you at all times your blood sugar may drop suddenly while on steroid treatment
- Wear a medic alert bracelet at all times
- Make a plan for increased insulin needs
- Continue to follow your regular eating plan and aim for regular physical activity
Effects Of Steroid Hyperglycemia
Despite its frequency, little is known about the impact of hyperglycemia associated with steroid use on clinical comorbidities and mortality. It is known that rheumatic diseases per se represent an important cardiovascular risk factor, which makes them the leading cause of premature mortality in these patients. Therefore, it is thought that the coexistence of inflammatory diseases and steroid-induced hyperglycemia may lead to worse cardiovascular consequences. Similarly the diabetic patient possesses a traditional cardiovascular risk factor for microvascular and macrovascular complications.
Fluctuations in serum glucose levels have been associated with increased cardiovascular mortality associated with increased LDL cholesterol, endothelial dysfunction, activation of the coagulation cascade, increased pro-inflammatory cytokine production, and oxidative stress resulting in macrovascular disease progression. Several studies have reported that transient increases in serum glucose are associated with acute inflammatory processes and endothelial dysfunction in both diabetic and non-diabetic patients.
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Risk Factors Of Steroid
There are some factors that may mean you are more likely to develop diabetes if you are taking steroids. These include if you:
- are over 40 and white, or over 25 and African-Caribbean, Black African or South Asian
- have a close family member with type 2 diabetes
- are of African-Caribbean, Black African or South Asian descent
- have had high blood pressure
- are living with obesity.
Weve got lots more information about the different diabetes risk factors. If you are taking steroids as part of your treatment for a health condition, or if you are about to start, use our Know Your Risk tool to find out your risk of developing diabetes.
When Do Steroids Start To Affect Blood Sugar
Steroids may start to affect your blood sugar pretty quickly after starting treatment, although it depends on what course of treatment youre on.
For oral steroids, blood sugars may begin to rise within a few days of treatment. The effects will depend on the dose and type of steroid you are taking.
Steroid injections start to affect blood sugars soon after the injection and can remain high for 3-10 days afterward.
If youre taking topical steroid creams or gels or inhaled steroids, they do not typically affect blood sugar levels.
Food To Avoid While On Prednisone: Sugar
First of all, we focus on sugar and avoiding it. Sugar is basically poison to people taking prednisone especially simple sugar like white sugar, white rice, white flour, those refined carbohydrates that your great-great-grandmother has never heard of. She has never seen things like candy in wrappers. We need to focus on foods that she would recognize. We need to stay out of the middle of the grocery store and focus on traditional foods that people have eaten for millennia. Only the real foods, whole foods: that is how we can avoid having too much sugar. So what exactly aside from flour and sugar am I talking about?
I am talking about things that come out of the bakery like bread, rolls, boggles, donuts, or all those good delicious things. Especially, when theyre made of white flour. Theyre really bad for us especially when we are on prednisone. They turn right into sugar and straight into fat and all of those horrible consequences of high blood sugar.
- Food Examples
- Bakery: Cookies, Cakes, Bread, Donuts, Rolls
- Frozen Meals
What To Do When You Stop Steroid Therapy
Its important to know what to do when you stop steroid therapy, to avoid negative health consequences, especially when managing diabetes.
Some strategies to help when stopping steroid therapy include:
- Work with your endocrinologist about tapering off the amount of insulin youre taking each day to reflect tapering down your steroid use
- Make sure you dont immediately stop taking your steroid therapy work with your prescribing physician to taper your medication. Abruptly stopping steroid therapy can make you very sick.
- Make sure you check your blood sugars more often than normal while tapering steroid therapy
- Carry extra low-snacks, as fluctuation in blood sugars is common while tapering other medications
- If your blood sugar remains high for more than 2 or 3 days after stopping steroid therapy, contact your doctor immediately
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High Sodium From Prednisone
- Water retention
- High blood pressure
The first lab value changed by prednisone is sodium which is also known as salt. High sodium causes bloating and water retention, which leads to high blood pressure. High sodium is also known as hyperkalemia. The normal range of sodium is 137 to 146. You can see on my lab result that my sodium is technically in a normal range.
That might be true for some of these other labs that youll see going forward, that the lab result is technically within the range of normal, but its not my normal! Its definitely not my optimal level.
You can see in the chart before I took prednisone, before 2017, it was lower. And after I took prednisone, the numbers drop off or back to normal.
You can see in red the time when I used prednisone. The S on the sodium chart during that time shows that sodium shot way up. And then while I was on chemo is where that big dip happened in April 2018.
What we learn from this is that sodium is retained. We hold on to sodium while were on prednisone. Sodium levels go higher while on prednisone.
Upswing: Steroids And Water Pills
People take corticosteroids, such as prednisone, to treat rashes, arthritis, asthma, and many other conditions. But they can boost your blood sugar, and may even trigger diabetes in some people. Diuretics that help high blood pressure, also called water pills, can do the same. Some antidepressants also raise or lower blood sugar.
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Can Steroids Increase Blood Sugar
The blood sugar increase from the now not-too-sugary tomato juice is offset with the aid of the reality that pure-grain alcohol in the drink The amount steroids or different medicines boost blood sugar will depend upon the person. We all have slightly unique genetic make-up and body composition, so a medicine which.
These both act to growth blood sugar level. At the identical time steroidal hormones additionally help to growth peripheral resistance to movement of insulin. So lower.
In these sufferers, steroids which may be persisted even after discharge, can enhance the blood sugar tiers,” says Dr George. 2. Coronavirus spike protein can damage beta cells in pancreas “Also.
The incidence of this facet effect relies upon at the dose, sort of steroid and period of treatment. The growth in blood sugar level will.
Many those who didnt have diabetes are observed to had higher blood sugar tiers after restoration. Besides, excess use of steroids or steroid abuse also can growth the risk of diabetes. Thus.
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What reasons excessive blood sugar? To higher manipulate hyperglycemia.