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What Is the Connection between Steroids and Diabetes?

By Synthia L. Rose
Updated Feb 09, 2024
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A potential cause-and-effect relationship exists between steroids and diabetes, with some steroidal prescriptions triggering the onset or exacerbation of diabetes. Steroids, such as prednisone, dexamethasonehydrocortisone and dexamethasone, can cause the liver to release too much glucose and cause the body to develop insulin-resistance, resulting in high blood sugar levels. Insulin is necessary to change glucose to energy and keep blood sugar balanced.

Depending on the productivity of the pancreas, prescription steroids can make even those not genetically predisposed to diabetes develop the condition. If the pancreas senses the body is not effectively using insulin in the presence of steroids, it may release additional insulin to combat the problem. Without additional insulin or if the body resists the insulin, a medical condition known as steroid-induced diabetes develops. For those that have diabetes already, taking steroids could worsen it.

This link between steroids and diabetes is usually temporary, lasting roughly three days and vanishing when steroid medication is completely discontinued. For people on long-term steroid therapy, diabetes could be chronic, however. To avoid the negative side effect of steroids and diabetes, many doctors prescribe steroids at low dosages or use another type of medication to treat inflammatory issues, such as asthma or arthritis, which are the two most common conditions for which steroids are taken.

Single-shot injections with 35 mg or less of a steroid are unlikely to trigger high blood sugar even in diabetic patients, studies show. Dosages of 50 mg or more, however, do typically elevate blood sugar. If high dosages of steroid medication must be used, some doctors opt to concurrently prescribe high dosages of insulin, particularly for patients at high risk of developing steroid-induced diabetes. Physicians advise daily monitoring of blood glucose levels for steroid users.

The reason for this correlation between steroids and diabetes is not fully understood by scientists. Preliminary studies on mice suggest that steroids interfere with fatty acids in the liver so that they can no longer activate a special protein known as peroxisome proliferator-activated receptor-alpha (PPAR-alpha). Without functioning PPAR-alpha, studies found that blood sugar built up and insulin-resistance ensued. Another simpler theory is that oral and epidural steroids decrease chromium in the body, which is a key nutrient required to control blood sugar.

Certain people are more susceptible to the negative relationship between steroids and diabetes. Children who have Crohn's disease and use steroids regularly are at high risk of developing steroidal diabetes. Aging patients with neurological disorders are also at greater risk.

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Discussion Comments
By anon989468 — On Mar 08, 2015

"Single-shot injections with 35 mg or less of a steroid are unlikely to trigger high blood sugar even in diabetic patients, studies show. Dosages of 50 mg or more, however, do typically elevate blood sugar."

35, 50 mg injections of what? What are we talking about, prednisone? Dexamethasone? Or cortisone?

By anon961002 — On Jul 14, 2014

I have rheumatoid arthritis. I have taken prednisone on and off most of my life with either the packs, daily, or shots for sore joints. The last few years I have been on prednisone constantly and developed type 2 diabetes and high cholesterol. Also all the other lovely side effects of steroids, e.g., facial hair, hump on back.

I have tried different diets so I didn't have to go on meds for diabetes, (I was not a refined carb eater until I tried being a vegan). I waited a whole year. I had to go off RA meds for another side effect so there’s no way could I go off steroids. I still haven't dealt with the cholesterol. The diet worked a little for the cholesterol, but I think the damage is done, and I need a pill for diabetes.

By SteamLouis — On Jun 22, 2013

@burcinc-- Some steroids affect the function of hormones, including insulin. So it's possible for long-term steroid use to cause diabetes (generally type two).

I'm a vet and even though I don't know anyone who developed diabetes from steroids, I do know several cats and dogs who have. The interesting part however is that the diabetes disappeared once steroid therapy was stopped. So it was not permanent.

By burcinc — On Jun 22, 2013

@burcidi-- Wow, that's terrible.

But has anyone developed diabetes from steroid use? I've never heard of anyone who has.

By burcidi — On Jun 21, 2013

I learned how steroids can worsen diabetes through my personal experience.

I have type two diabetes and despite knowing this, my doctor gave me a cortisone shot for inflammation. I have a lumbar herniated disc that gives me unbearable lower back pain from time to time. My doctor said that this shot would relieve the pain.

Soon after getting the shot, I started getting abnormally high blood sugar readings. I was taking more medication and still my blood sugar would not go down. Thank God that I don't have type one diabetes or have extremely high blood sugar readings. If I had a more serious form of diabetes, that cortisone shot could have caused very serious complications. I could have even gone into a coma!

It took two weeks for my blood sugar to go back to normal after that one single shot of steroids. Of course, I never went to that doctor again. I can't believe how irresponsible some doctors can be.

If anyone who's reading this has diabetes (or diabetic family members), please be careful about taking steroids. It's best to avoid them unless it's absolutely necessary. And make sure to keep a close eye on your blood sugar during this time.

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