Diabetes & Steroid Therapy

Issued by the Diabetes Service

Northumbria HealthcareNHS Foundation Trust

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What are Steroids?

Steroids (Corticosteroids) are a group of medicines that can beused in the treatment of many conditions such as asthma,inflammatory bowel conditions, arthritis and cancer therapy. Taking steroids can often cause a rise in blood glucose (sugar)levels. However, it is very important that you finish the full courseof steroids prescribed to you. If you have any concerns about thisplease contact the person who prescribes medication for you.Steroids can cause your body to become resistant to either theinsulin your body produces or the insulin you inject.The rise in blood glucose levels will usually start one or two daysafter starting steroids, and this more commonly happens in theafternoon and evening which may require an increase in your daytime diabetes treatment. Blood glucose lowering treatment will be based on your glucoselevel patterns and how long you will be taking the course ofsteroids.Your blood glucose levels should return to their previous levelsone or two days after stopping your steroids.

What will happen?

Depending on the length of the course of your steroids and whilstyour blood glucose levels are high, you may need to start orincrease blood glucose lowering medication/treatment. This mayinclude: dietary/lifestyle advice, tablets, insulin or GLP-1.You will be taught how to test your own blood glucose levels, ifyou are not already doing this,and how to react to high or lowreadings.

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If your diabetes is treated by:Diet/lifestyle alone – you may need tablets to reduce yourblood glucose whilst taking steroids. Tablets – you may need to increase your blood glucose loweringtablets or possibly use insulin whilst on steroidsInsulin – you may need to increase your insulin dose whilsttaking steroids and/or use a different type of insulinIf your blood glucose levels regularly rise above 15mmol/L, youshould contact your GP or diabetes clinic to arrange a reviewand possible change in diabetes treatment whilst on steroids. Your treatment will be based on your blood glucose levels andhow you will be on your steroid course.

Steroid Induced Diabetes

What is ‘steroid induced diabetes’?

Steroid induced diabetes is the discovery of higher than normalblood glucose levels after starting steroids in people notpreviously known to have diabetes.

Why does it happen?

Blood glucose levels are normally controlled by a substancecalled insulin which is naturally produced by a gland called yourpancreas. Steroids can cause your body to become moreresistant to the insulin produced causing blood glucose levels torise.

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The facts

The rise in blood glucose levels will usually happen between oneor two days after starting steroids, and you will probably find thatthis will happen more commonly in the afternoon and evening.Your blood glucose will return to previous levels one or two daysafter stopping your steroids. With steroid induced diabetes some people will continue to havehigh blood glucose levels after the steroid course is finished. Thisis because the blood glucose levels were raised before takingsteroids but they were unaware of it. If this happens, your GP ornurse will discuss this further with you.

How will I know if my blood glucose levels havereturned to normal after finishing steroids?

When/if your steroids are stopped you should be tested fordiabetes with a blood test. Please contact your GP to arrangethis.

What are the benefits of treating my high bloodglucose?

High blood glucose levels can cause you to feel unwell. Inparticular you may become thirsty, tired, pass more urine and cansometimes require hospital admission.

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What problems can treating high blood glucosecause?

The main problems arise when people are taking too muchtreatment for high blood glucose. This only happens on tablet andinsulin treatment. This can cause low blood glucoses below4.0mmol/L (hypos). You will be given specific instructions abouthow to recognise these and avoid them.

Remember

If your steroids are reduced or stopped your blood glucose levelsmay fall, usually after one or two days. You will be advised tocontinue to check your glucose levels, and if you are taking bloodglucose lowering tablets or insulin these may need to be reducedor stopped.

Please contact your GP/Diabetes team for advice ifany alteration is made to your steroid dose.

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Useful Contact Numbers

GP: ________________________________________________

Diabetes Nurse/Team: ________________________________

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PIN 035/V4

Review date: August 2017

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