Steroids are often used to treat conditions that reduce inflammation and swelling. These are hence used to treat or prevent certain ailments. Steroids do have some side effects the most commonly discussed concern is that of increasing blood sugar levels. One of the major concerns in the minds of people is, do steroids raise blood sugar in non-diabetics.
Studies have confirmed that steroids, which are used for their anti-inflammatory and immunosuppressive properties also have several side effects and that hyperglycemia is the commonest one.1
Do Steroids Raise Blood Sugar In Non-Diabetics?
Steroids are a type of medicine used to treat certain conditions like allergies, asthma, irritable bowel syndrome, and rheumatoid arthritis or in conditions like Addison’s disease where the adrenal glands are unable to produce natural steroids. Steroids can suppress the immune system and hence, are also used to prevent organ rejection in patients having received organ transplantation.
There are various types of steroids and there are different forms in which steroids are taken. The impact of steroids on blood sugar levels may vary from person to person and also based on their type.
The side effects of steroids can be classified into three categories.1
- Immediate – Fluid retention, weight gain, insomnia, blurred vision, mood swings, changes in the immune system
- Gradual Effects – Changes in endocrine metabolism, hyperglycemia, dyslipidemia, obesity, osteopenia. Also, acne, dyspepsia, and skin thinning can occur gradually
- Idiosyncratic Effects – Cataracts, open-angle glaucoma, avascular necrosis, and psychosis.
Studies have reported that steroids are the main cause of drug-induced hyperglycemia. Steroids can not only increase hyperglycemia in patients with diabetes mellitus but can also cause diabetes mellitus in patients who were not known to have hyperglycemia before the initiation of glucocorticoid therapy.1
Methylprednisolone pulses are used in the treatment of various disease conditions. A study was conducted to evaluate metabolic changes and glucose disturbances in non-diabetic patients receiving acute treatment with prednisolone pulses. The study reported that the pulses increase glucose levels in both diabetic and non-diabetic patients and thus concluded that methylprednisolone pulses resulted in a significant increase in fasting glucose in most patients without diabetes.2
This clearly shows that steroids do raise blood sugar in non-diabetics.
How Do Steroids Raise Blood Sugar Levels In Non-Diabetics?
Steroids can affect the way your body reacts to insulin, which is responsible for controlling your blood sugar levels.
Insulin hormone is produced by the pancreas and its main function is to help proper utilization of glucose by the body cells, thus lowering the blood sugar levels. However, when you are taking steroids, your liver may produce more glucose but your body is unable to make enough insulin to utilize that glucose. Thus, the function of insulin is affected and it does not work efficiently, which is known as insulin resistance. The muscles and fat cells in the body are unable to absorb glucose and the levels of glucose in the blood begin to rise to result in hyperglycemia.
Steroids can raise blood sugar levels in non-diabetics and it can increase the risk of developing diabetes if you are prescribed steroid pills more frequently or in large doses.3
The risk may be more in people who have a family history of diabetes or in those women who developed diabetes during their pregnancy, also called gestational diabetes.
A 2020 study reports a case, in which a woman developed diabetic ketoacidosis after treatment with methylprednisolone for immune thrombocytopenic purpura. She was a non-diabetic, with no family history of diabetes. It was a result of mainly steroid-induced hyperglycemia with insulin resistance, ketogenesis, and lipolysis.4
The signs and symptoms of raised blood sugar due to steroids include increased frequency of urination, particularly at night, feeling thirsty more often, feeling more tired than usual, and losing weight without trying to.5
What Is The Treatment For Raised Blood Sugar Due To Steroids?
While steroids can raise blood sugar in non-diabetics, the need for treatment to lower blood sugar levels will depend upon the type and duration of steroid therapy.
If the treatment duration is short and temporary, the effects on blood sugar levels may also be short-lived in most cases. Usually, the blood glucose levels can again lower down to their original range once the steroid treatment is over. However, in some, other health conditions, genetic factors, diet, and lifestyle choices too may influence blood glucose levels after the steroid treatment is over.
Those receiving long-term steroid therapy may have long-term concerns about raised blood sugar levels. It is therefore necessary to follow medical advice and keep a check on your weight, diet, and routine.
The need for treatment for drug-induced hyperglycemia or raised blood sugar due to steroids will depend on several factors. Your doctor will closely monitor your blood glucose levels and prescribe medications to control blood glucose during steroid therapy, as required.
Thus, it is clear that steroids can raise blood sugar in non-diabetics just as they can raise blood sugar in diabetics and increase the risk of complications.
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