In a perfect world, the answer to the question “should someone with diabetes take steroids?” would be a simple “no”. Of course, not only do we not live in a perfect world, there are also few simple answers for diabetics. Steroids can play havoc with blood sugar levels, but they can also be the best choice in treating some very serious conditions. So, perhaps the better answer would be “maybe” with the added caveat of making sure you are aware of the consequences and prepared to be proactive in managing them.  

Steroids are frequently prescribed to treat a wide range of conditions, some relatively minor such as rashes, muscle spasms and pain, injuries and respiratory issues. These normally require only a short period of use. They are also used long-term for conditions like certain inflammatory disorders, asthma, arthritis, autoimmune disorders and organ transplants. Steroids can be exceptionally effective. At the same time, they also significantly increase blood glucose levels in people with diabetes. This is done by a combination of making the liver resistant to insulin, causing the liver to release extra glucose into the bloodstream and, also, making it more difficult to move the glucose into the muscles. Blood sugar levels can quickly spiral out of control and be very difficult to manage.

Side Effects of Steroid Use

These are not the only side effects of steroid use that are related to diabetes management but are among the most commonly experienced:

• Elevated and fluctuating blood glucose levels
• Increased hunger
• Difficulty with digestion
• Increased weight
• Fluid retention, including the trademark puffiness in the face
• Increased risk of infections

Before prescribing steroids for anything, one of the first things a physician will do is check your medical history, and diabetes will always be a red flag due to the effect on blood sugar levels. For some issues, there will be alternative treatments that may be tried instead. For others, however, like with some of the autoimmune disorders, there may not be viable options. It will be very important for your endocrinologist to be involved so that your blood glucose levels can be monitored more closely and insulin dosages adjusted.

It can be very disheartening for someone already dealing with the daily struggles of diabetes to be diagnosed with a new challenge, especially one where treatment may interfere with the precarious blood sugar balancing that has become a way of life. It will help to try and get regular exercise, maintain a healthy eating plan and consistently get a good night’s sleep. Your physician may also have other suggestions for making this period a little easier to manage.