Steroids and Your Blood Sugar

Steroids and Your Blood Sugars

Patient Information

Diabetes Service

• Author ID:     AO
• Leaflet ref:    DB 001
• Version:        4
• Leaflet title:   Steroids and your blood sugars
• Last review:  December 2024
• Expiry date:  December 2026

Introduction

We have written this leaflet to explain about some of the effects of taking steroid medicines.  Steroids can cause blood sugar (glucose) levels to rise. People with known diabetes may find it harder to control.  Also some people who did not have diabetes before may develop diabetes after taking steroids (this is called secondary diabetes and it often resolves after the steroids are stopped).

What are Steroids

Steroid medications are powerful drugs used to treat many conditions such as asthma, cancer, chronic lung disease, arthritis, many skin conditions and some types of blood disorders or eye conditions.  Steroids work mainly by reducing inflammation.  Types of steroid medications include prednisolone, hydrocortisone and dexamethasone.

Why does blood sugar rise?

Blood sugar levels rise during steroid treatment because your liver produces more glucose than normal and your body is not able to produce enough insulin to cope with this increase.  Insulin is a substance produced by the pancreas and regulates blood sugar levels.

Steroids can also cause your body to become resistant to either insulin produced by your own body or insulin you may be injecting to control your diabetes.

What will happen when I take steroids?

Your blood sugar may go up within half a day or so after starting steroid medication.  This usually occurs in the afternoon and evening if you take your steroids first thing in the morning.

If you take steroids more than once a day, then your blood sugar may rise throughout the day.  The bigger the dose of steroids, the more likely that it will affect your blood sugar.

For patients who do not have diabetes prior to commencing steroids

You will be taught how to test your own blood sugar level on a blood sugar meter.

• Test your blood sugar every day before your evening meal.
• If below 11mmol/L on 3 consecutive tests, then you can stop testing.
• If above 11mmol/L, please increase your testing to 4 times per day.  Test before each meal and before bed.
• If these results are above 11mmol/L but less than 20mmol/L, in the same day, please ring the Diabetes Specialist Nurse (DSN).
• If the results are above 20mmol/L, please ring the DSN or if not available, seek emergency medical advice (see below).

For patients who have diabetes prior to commencing steroids

If you do not already test your blood sugar levels, you will be provided with a blood sugar meter.

• Test your blood sugar level 4 times a day.  Test before each meal and before bed.
• If these results are above 11mmol/L  but less than 20mmol/L in the same day, please ring the Diabetes Specialist Nurse (DSN).
• If the results are above 20mmol/L, please ring the DSN or if not available, seek emergency medical advice (see below).

Emergency Medical Advice

If your blood sugar is above 20mmol/L and you are unwell and/or vomiting, attend your local Accident and Emergency Department  immediately.

If your blood sugar is above 20mmol/L and you feel well, please ring your GP/out of hours service.

Contact Telephone Numbers

For Wigan Diabetes Nurses

Wigan Diabetes Centre 01942 822188 

Monday to Friday 9am until 5pm.

For Leigh Diabetes Nurses Leigh Diabetes Department 01942 264109 

Monday to Friday 9am until 5pm.