Steroid drugs can cause an increase in blood sugar levels, known as steroid diabetes, which can be temporary or persist after stopping the medication. Treatment options include reducing medication and monitoring glucose levels. Patients with a family history of diabetes should discuss the risk before taking steroids.
Steroid diabetes is an increase in blood sugar associated with steroid drugs in some patients. In these patients, fasting glucose levels are similar to those seen in other forms of diabetes, and although insulin may be present in the body, it cannot regulate blood sugar adequately. Steroid diabetes is typically temporary and will resolve after the patient stops taking the drug. For some people, it persists, usually because steroids have exacerbated an existing case of diabetes and made it apparent, not because steroids have caused long-term diabetes in the patient.
Patients can take steroid medications for a variety of inflammatory conditions. These drugs have an immunosuppressive effect which can be useful for preventing organ rejection and treating patients with autoimmune diseases. Rising blood sugar is a common side effect. These can remain relatively mild, or could be severe enough to cause diabetes, where levels range dangerously high and cannot be controlled.
If a doctor suspects a patient has steroid-induced diabetes, a fasting blood glucose test may be ordered. This allows a technician to check blood sugar levels in someone who hasn’t eaten in a while, when they should be low. High levels indicate an imbalance. A follow-up may be recommended to make sure the patient’s blood sugar was not high due to stress or other factors; for example, a child who is frightened and nervous after sitting in a waiting room might have high fasting blood sugar.
In cases where patients develop steroid diabetes, there are several treatment options. One is to cut back on medications and see if the diabetes clears up. Another is to continue using steroids because they are medically necessary, but to monitor the patient and make some recommendations to keep glucose under control. People may need to take steroids to stay alive in some cases, in which case stopping the medications or changing the dosage may not be an option.
People with a family history of diabetes may also want to discuss the risk of having a mild case of diabetes before taking steroids. Further tests can provide more information. This can help narrow down treatment options for steroid diabetes, which can vary depending on the origins of the condition. If steroids made a case of diabetes worse, measures like better diet and exercise controls could offset the rise in blood sugar and keep the patient stable. Once the patient stops taking the steroids, follow-up tests can determine if the diabetes is more under control or if it persists.
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