Steroid diabetes is a rise in blood sugar in association with steroid medications in some patients. In these patients, fasting glucose levels are similar to those seen in other forms of diabetes, and while insulin may be present in the body, it cannot adequately regulate blood sugar. Steroid diabetes is typically temporary and will resolve after the patient stops taking the medication. For some people, it persists, usually because the steroids exacerbated an existing case of diabetes and made it apparent, not because the steroids caused long-term diabetes in the patient.
Patients may take steroid medications for a range of inflammatory conditions. These medications have an immunosuppressive effect that can be useful for preventing organ rejection and treating patients with autoimmune disorders. Increases in blood sugar are a common side effect. These may stay relatively mild, or could be severe enough to cause diabetes, where levels range dangerously high and cannot be controlled.
If a medical professional suspects a patient has steroid diabetes, a fasting glucose test may be requested. This allows a technician to check the 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 wasn’t high because of stress or other factors; for example, a frightened child nervous after sitting in a waiting room might have high fasting glucose.
In cases where patients develop steroid diabetes, there are several treatment options. One is to taper off the medications and see if the diabetes resolves. Another is to keep using steroids because they’re medically necessary, but to monitor the patient and make some recommendations for keeping glucose under control. People may need to take steroids to stay alive in some cases, in which case stopping the drugs or changing the dosage may not be an option.
People with a family history of diabetes may also want to discuss the risk that they had an underlying mild case of diabetes before taking steroids. Additional testing can provide more information. This may help with narrowing down treatment options for steroid diabetes, which can vary depending on the origins of the condition. If the 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 steroids, follow-up tests can determine if the diabetes is more under control or if it persisted.