I will be getting a course of steroid treatment. I heard this could throw my diabetes out of control. What should I do?
Steroids are a type of medication based on com-pounds naturally produced by the body. Naturally occurring steroids are of several types, but one type, the glucocorticoids, have anti-inflammatory properties and are used to combat inflammation in a variety of conditions from asthma and allergic reactions to serious chronic diseases such as chronic bronchitis (COPD) and rheumatoid arthritis.
Short courses of potent steroids, which can be given by mouth or injection, are generally effective and safe, but have the tendency to raise the blood sugar.
Depending on the dosage, the potency of the steroid itself, and the underlying condition for which they are given, they can raise the blood sugar by a modest to a very marked degree.
This will usually occur within a day of starting the course and will persist until the dosage is either lowered to levels normally produced by the body, or until a few days after discontinuing their use.
In the case of a steroid injection given into an area of inflammation, such as the spine or a joint, the elevated blood sugars may persist for several days or even weeks, but are generally not as severe as when steroids are orally administered.
In some people, administration of steroids may expose their tendency to diabetes for the first time.
If you have diabetes and are either managed by pills or lifestyle adjustment alone, a course of high dose steroids may mean that you will need to take insulin for a period of time. This is because steroid-induced high blood sugars do not respond well to pills.
Some-times, when the course of steroids will be short, elevation of blood sugars, unless excessive, can be tolerated with the knowledge that it will resolve fairly rapidly when the medication is stopped.
You should monitor your blood sugars regularly during a course of steroids and contact your doctor if the readings are climbing much above usual levels.
Steroids taken in the morning often only have the tendency to raise the blood sugar in the afternoon and evening, with a return to your usual level by the next morning, so this is an expected pattern.
If you already take insulin, you will probably need to raise your insulin dosage to combat rising blood sugars.
Your doctor or diabetes educator can give you a strategy to do this, using supplemental insulin and possibly increasing your usual set doses, also.