Autumn is approaching with its beautiful fall foliage, hayrides at the pumpkin patch, and harvest festivals, as well as its sniffles and running noses. Cold and flu season is a drab for everyone, but can be particularly worrisome for people with diabetes. In addition to worrying about how being sick will affect their glucose levels and whether or not cold and flu medications are sugar free, being prescribed corticosteroid (steroids) adds a whole other layer of concern. Medtronic Diabetes Clinical Manager, Beth Spencer Kline, MSN, RN, NP-C, CD is back to discuss an important aspect of diabetes management, steroid effects on blood glucose.
What are steroids?
Steroids are medications used to reduce inflammation and suppress the immune system. Steroid treatment is commonly prescribed for short periods of time to treat conditions such as rashes, musculoskeletal pain, injury, and respiratory ailments. However, steroids can also be prescribed for longer periods of time to treat certain inflammatory disorders, autoimmune disorders, and organ transplants. While steroids can help reduce inflammation and reduce pain, they can also significantly increase blood glucose levels in people with diabetes, as well as individuals with impaired glucose tolerance or pre-diabetes. Why is this? Steroids increase the liver’s release of glucose, and cause insulin resistance, which leads to insulin (either injected or made by one’s own pancreas) working less efficiently.
What if I’m prescribed steroids and have diabetes?
First, let your prescribing doctor know you have diabetes, because they may be able to prescribe an alternative medication that will not affect your glucose levels. If alternative medication is not an option, inform your diabetes healthcare team immediately so they can determine what adjustments need to be made to keep your blood glucose levels within your target range. Your pharmacist and your healthcare team should be your chief resources for questions about any medication that you are taking.
What should I keep in mind while taking steroids?
1. Steroids don’t elevate glucose levels consistently throughout the day, so you may need to check your blood glucose more frequently. Your healthcare team will determine how often. You may find this glucose monitoring guide helpful.
2. You may need to increase your insulin doses to accommodate the increase of insulin needs. Talk to your healthcare team about using the temporary basal rate or adjusting your basal pattern, and adjusting using your mealtime insulin dose.
3. Test your urine for ketones, as directed. Notify your healthcare team immediately if your ketone levels are moderate to high, your glucose levels remain high after their advised insulin adjustments, or you’re experiencing nausea, vomiting, or shortness of breath.
4. Carry fast-acting carbs, such as glucose tablets/gels, fruit juice, or regular soda, to treat hypoglycemia in case your glucose levels drop.
What if I change or stop my steroid dose?
Eventually, your healthcare team will taper down your steroid prescription. It’s important to not stop your steroids prematurely, as this may cause significant illness. When your steroid doses are tapered, your insulin doses will likely need to be lowered as well. Continue to check your glucose levels as advised, and discuss your insulin regimen with your healthcare team.
Being under the weather is no fun, but if you have diabetes and are prescribed a steroid, frequently testing your blood glucose and proactively communicating with your healthcare team will help you stay as healthy as possible this cold and flu season!
Editor’s Note: You may remember Beth from her previous blog post Misconceptions About Insulin Pump Therapy And Type 2 Diabetes.
Tags: blood glucose
, diabetes management