Steroid-Induced Diabetes
With Halloween soon approaching, just going into a store can be risky because of the Halloween candy displays. And who doesn’t love candy? Especially those of us who manage #Myositis with corticosteroids such as Prednisone, because steroids often stimulate the appetite and make sweets especially appealing.
It can be difficult for anyone to avoid these temptations, but just as the use of corticosteroids increase our appetite and cravings for sweet treats, the use of steroids also increase our chances of developing steroid-induced diabetes.
HOW STEROIDS AFFECT INSULIN
Corticosteroids counteract the effects of insulin, which makes your pancreas work harder to pump insulin to keep your blood sugar normal. A normal pancreas does this quite effortlessly, but if your pancreas works a bit ‘on the edge’ so to speak, it cannot cope with this demand for extra insulin and your blood sugars rise. In other words your pancreas may work well under normal circumstances, but it doesn’t handle the stress of the steroids well.
The good news for most people is that the diabetes will go away once the steroids are reduced or stopped. Unfortunately for others, the beta cells of the pancreas have been destroyed to the point that not enough beta cells are left, and diabetes will be a life-long issue.
If you are prescribed steroids, especially long-term (more than a few months), talk with your doctor about your risk of developing diabetes and discuss strategies for helping to prevent it.
DANGERS OF DIABETES
Diabetes should never be ignored. It is a destructive disease which can cause long-term and life- threatening damage to large blood vessels of the heart, brain and legs and of the small blood vessels, creating problems with the eyes, kidneys, feet and nerves.
Kidney failure, neuropathy, skin ulcers, gum disease, stroke, erectile dysfunction, decreased wound healing and increased incidence of infections are common issues which develop as a result of diabetes.
TEAM UP WITH YOUR DOCTOR
If you are prescribed steroids, especially long-term (more than a few months), talk with your doctor about your risk of developing diabetes and discuss strategies for helping to prevent it.
Symptoms of diabetes include: dry mouth, increased thirst and/or hunger, increased urination, fatigue and blurry vision.
Not everyone has noticeable symptoms of diabetes. Having regularly-scheduled blood work is a good way to detect any variations which may indicate that your glucose levels are changing.
Normal blood sugar levels are between 70 and 99 mg/dL when fasting and less than 140 mg/dL two hours after eating.
Your doctor may also suggest running an A1C test periodically, which is a 90-day average of your blood sugar levels.
TREATMENT
Dietary changes and exercise are helpful in managing diabetes, and there are many medications available both in pill and injectable forms. People with diabetes should be aware that their medications for diabetes may need to increase with steroid use and decrease as the steroids are tapered or ceased. Close monitoring on a daily basis is essential.
THE TREATS DON’T END HERE
The temptations don’t end at Halloween. Halloween is just the beginning of a 2-month holiday season when many of us overindulge at family gatherings, social engagements and office parties when temptations are present at every turn. It is wise for everyone to use good judgment and moderation, but it is especially true if we are more susceptible to diabetes from steroid use.
I was recently diagnosed with Steroid Induced diabetes (or possibly autoimmune related diabetes). My doctor told me there would be a 50% chance that it would resolve when I stop prednisone.
Hard part is I am underweight and trying to gain but have made dietary changes anyway. The doctors are unable to control my glucose though. It runs in the 400’s most days and I am now on three meds for it. Anyone else experience this?