How steroids affect blood sugar
Glucocorticoids, or steroids as they are commonly known, are hormones that are named for their role in glucose metabolism (the breakdown of sugars). Steroids come in both natural forms (like cortisol, estrogen and testosterone) that are made by the body to help regulate internal processes; and external, synthetic forms (such as prednisone or prednisolone), which are used to treat inflammatory diseases.
If you’ve been prescribed steroids, you may find they affect your ability to control your blood sugar levels. Steroids tend to raise blood sugar, sometimes to dangerous levels, and with important short and long-term consequences.
Why does this happen?
Steroids increase blood sugar levels by altering the use of glucose in different organs in the body. For example, treatment with steroids encourages the liver to make more glucose, while reducing the amount absorbed by the muscle and fat tissues. The sum of these effects on different organs leads to an overall blood sugar level that’s higher than normal, a state that doctors refer to as “hyperglycemia”.
Steroids and diabetes
While it certainly doesn’t happen to everyone who takes steroids, sometimes the impact of steroid use on a patient's blood sugar is so dramatic that they become diabetic. This means that they can no longer control their blood sugar levels normally and start to lose glucose in their urine (pee).
For those who already have diabetes, steroid treatment can make managing blood sugar even more challenging than usual. That's because steroid medications can decrease the effectiveness of insulin, the hormone that usually helps the body maintain normal blood sugar levels. In steroid-treated patients who are prone to diabetes, higher and higher levels of insulin are required to maintain normal blood sugars.
“High blood sugar levels can make you feel thirsty, tired and dizzy.”
What to look out for
High blood sugar levels can make you feel thirsty and increase how often you need to visit the bathroom (to pee). They can also make you feel tired or dizzy and lead to numbness and tingling sensations in your hands, legs and feet.
Top tips for managing your blood sugar
1. Have your blood sugar measured when starting steroids
Blood glucose measurements are simple, and part of routine blood tests performed at doctor’s visits. Patients starting steroid treatment should have a random blood glucose measurement checked to make sure they are not already hyperglycemic (i.e., have blood sugar levels that doctors consider to be too high).
2. Have your hemoglobin A1c (HbA1c) level checked
HbA1c is another routine blood measurement. It’s used to help doctors assess how effective a person’s blood sugar control has been over the last 3 months. It’s important to measure HbA1c when steroid treatment starts and to monitor these levels regularly for as long as steroid treatment continues.
3. Monitor your blood sugar regularly
Keep a close eye on both your blood sugar levels and HbA1c values, especially if you are diabetic or at risk of diabetes. Regular monitoring can help you and your doctor understand how your body is responding to the medication and make plans to adjust your treatment if necessary.
4. Try to eat a balanced diet
Aim for a diet that’s rich in whole foods, fibers and lean proteins like white fish and beans, while avoiding high-sugar and high-fat foods. These dietary adjustments can help reduce blood sugar spikes.
5. Stay active
Regular physical activity can help your body regulate insulin better, counteracting some of the impact of steroids.
6. Discuss medication adjustments with your doctor
If you find that managing your blood sugar is particularly challenging while you’re being treated with steroids, talk to your doctor. They might adjust your dose or prescribe medication to help.
7. Consultation with an endocrinologist
For patients with complicating factors, such as those who already have a tendency toward diabetes, early access to an endocrinologist (hormone specialist) can be helpful in developing a plan to manage blood sugars.
The bottom line
While steroids are essential for treating many inflammatory and autoimmune conditions, they can complicate blood sugar control. By keeping a close eye and monitoring your blood sugar levels, making lifestyle adjustments, and working closely with your doctor, you can manage these side effects effectively.
Remember, always consult your doctor before making any changes to your medication or lifestyle to ensure the best care for your specific health needs.