Diabetes Self-Management Blog

If you take any kind of medication for your diabetes management, whether that be metformin, sulfonylureas, exenatide (brand name Byetta), or insulin, for example, hopefully you’re familiar with how that drug works and what the effect is on your blood glucose control.

But, just like people who don’t have diabetes, you’re going to come down with a cold or the flu every now and then.

You may need to take steroids for a while. Maybe you take medicine for controlling your blood pressure or your cholesterol. How familiar are you with these drugs, particularly in terms of your blood glucose levels?

Most of us are prescribed medicines for various reasons at one time or another. Unfortunately, we aren’t always told by our physician or pharmacist how they work and how they might interact with other medicines. And in the case of diabetes, chances are you’re not always given information on how a drug may affect your blood glucose level or how a it may interact with your diabetes medication—and many of them do.

Your pharmacist should be your number one source for any questions you have about any drug that you take. But we can scratch the surface and take a look at this important area of diabetes management. We’ll look at steroids this week.

Steroids
Steroids (corticosteroids, glucocorticoids) are a potent class of medications (meds for short) that are known to raise blood glucose levels, often quite significantly. Steroids are given to help reduce inflammation that may occur with arthritis or asthma. People with certain immune disorders, such as lupus, rheumatoid arthritis, or sarcoidosis, usually need to take steroids as well.

While steroids are very effective at doing what they’re supposed to do, one of the side effects is an increase in blood glucose levels. In fact, sometimes people find out that they have diabetes after being prescribed steroids for a certain condition because their health-care provider notices an increase in blood glucose levels. Others may develop what is called “steroid-induced diabetes,” which goes away after they stop taking these meds.

Why do steroids jack up glucose levels? First, they increase insulin resistance, causing your insulin (your own or injected insulin) to work less effectively in the body. This means that glucose levels build up in the blood. Second, steroids can trigger your liver to release extra glucose, again, leading to high blood glucose levels.

So, what do you do if your health-care provider prescribes steroids? Talk to the provider who is prescribing steroids to let him know that you have diabetes. He may be able to prescribe something else. But if that’s not an option, develop a plan of action with your diabetes team. Here’s what you’ll need to do:

  • You’ll probably need to check your blood glucose levels more often than you usually do—four or more times a day isn’t uncommon.
  • If you take insulin, you’ll likely need to increase your dose, for example, by up to 20% (often called a sick-day booster), depending on your glucose levels.
  • If you take pills, you may need to increase the dose, add another type of pill, or possibly even take insulin, temporarily. Again, this all is dependent upon the level of your blood glucose.
  • Call your health-care provider or diabetes educator if your blood glucose levels increase while you’re on steroids and your medication dose isn’t enough to bring them down.
  • Carry treatment for hypoglycemia (glucose tablets, juice, candy) with you in case your glucose levels drop suddenly.

Eventually, your steroid dose will be tapered down (steroids shouldn’t be stopped all of a sudden). At that point, your diabetes drug doses will likely need to be tapered, too. Checking your blood glucose levels will let you know what’s going on.

By the way, if you receive a steroid injection, expect the effect on your blood glucose to last up to several weeks. Steroid inhalers and creams usually don’t raise blood glucose levels.

More on meds next week!

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Comments
  1. I dont know if this is the forum, but I have a question I’d like to have addressed. I have type 2 diabetes (uncontrolled) and I’m presently using insulin. as a result of painful arthritis, I was given a cortisone injection and prescribed the drug, Celebrex. What is your opinion on this drug as it relates to persons with diabetes?

    Posted by elofford |
  2. I have had Type 1 diabetes for 33 years. For 4 or 5 years up to about a year ago, I had persistent bursitis in both my hips that made sitting for long periods and sleeping painful. Several times a year I would have steroid shots in both hips and within a day my blood glucose would shoot up and I would increase my basal insulin by 25 to 30%. This would last 2 to 3 weeks. Anyone who with diabetes who needs steroids should carefully monitor their glucose and make the appropriate adjustments. Then they need to carefully watch for the end of the side effects because it will change quickly.

    Posted by gbtaylor |
  3. I am one of those unfortunate ones who has to take steroids for asthma, and have type 2 diabetes. My glucose goes sky high, and I don’t know how to handle it. I take an amaryl to try to counteract it, but I’m afraid of amaryl because almost always I have such a low that it is frightening. What are the consequences if you don’t take something to make it go down, does your other organs get affected? And is that worse? I just can’t seem to grasp diabetes…I know about it but I don’t know about it….My gp doctor says I must take the amaryl if it gets higher than 150, but when I do the Prednisone…it goes into the 2 and 300…..range, it is scarey….if I take a whole one mg of amaryl it seems to be too much, but at the same time, it doesn’t seem to be enough. I can’t win for losing, but I have to be able to breathe, so I have to take the Prednisone….and I can’t see the harm that the high glucose numbers are doing to me….what are they doing to me? Tell me how I can win this game….it is a game of one med against another trying to beat your body down……gasp!!!!!

    Posted by sue |
  4. I am not a doctor, but from experience know that once you know your BG is low, TREAT IT and keep checking it.Ask your doctor to give you written instructions for the lows and the highs when s/he prescribes the steroids.

    Due to a brain tumor, I had to take a very potent steroid for months. I had BG’s in the 700’s and had Diabetic Ketoacidosis. I was very sick, but learned that being forewarned is being forearmed. I was put in the hospital and am now well. I asked the same question, and learned that it was a matter of treating the brain swelling (No choice) and treating the side effects (No choice). It is tough but with medical guidance one gets through this stuff. Conditions have to be treated. Don’t add to the problem with anxiety. The meds to treat both conditions are there to help you. Help yourself too. Keep learning about diabetes and how to take care of yourself. You can do it. Good luck.

    Posted by Millie |
  5. Hi sue,
    I can imagine how frustrated and worried you must feel. However, as Millie wisely put it, both of your medications are there to help you. The challenge is figuring out how to balance your diabetes with your asthma. You definitely don’t want to let your blood glucose levels run high (above 180 or so) for any length of time. Have you talked with your doctor about trying a medication like metformin (perhaps in place of or along with amaryl)? Metformin doesn’t cause hypoglycemia, so maybe it’s an option. In the meantime, check your glucose levels frequently so that you can stay ahead of any lows. If you see your glucose levels dropping too much, then treat them before they get too low. Also, I’d recommend you make an appointment with a diabetes educator who can help you work out a more refined diabetes treatment plan that works for you. Ask your doctor for a referral. Keep at it!

    Posted by acampbell |
  6. Hi elofford,
    Not being a pharmacist, I asked a pharmacist that I work with for some info on Celebrex. Here’s what she told me: Celebrex is known as a COX-2 inhibitor. This class of drugs is linked with an increased risk of cardiovascular events due to the incidence of edema and slight increases in blood pressure. People with diabetes are already at higher risk for cardiovascular problems because of their diabetes. Hopefully your provider has taken your diabetes into consideration while prescribing Celebrex. But if you’re not sure, talk with him/her about whether Celebrex is the best choice for you. Weigh the pros and cons. Also, I’m not aware that Celebrex has a direct effect on glucose levels; if you’re seeing high glucose levels, it’s likely, in part, due to the cortisone injection you received.

    Posted by acampbell |
  7. My stepdad is a type 2 diabetic. He just had found out he has a tumor on his voice box and was told he will have to do an MRI and he has to wait until next week. Now, he is having problems with breathing, hoarseness and no appetite. He just went to the Emergency Room and they gave him antibiotics and a steroid shot. He is still having the same symptoms: No appetite, can’t sleep because of shortness of breath and he still tries to smoke a cigarette. Will he be Okay ? i mean, he still has the shortness of breath and he can’t breathe to sleep at night a full 6-8 hours and he is in bad shape. Why the people at the Emergency Room sent him home, I don’t know. Will he be able to get low dose chemo for the tumor to shrink? He may need to have the voice box taken out but not be able to talk but he don’t want to go that route. Has anyone out there survived a tumor on the voice box?

    Posted by xena007 |
  8. Hi xena007,

    It sounds like your stepfather is going through a tough time. Has he been referred to a cancer specialist? Your questions are probably best answered by his physician and/or an oncologist. Also, as hard as it probably will be for him, one of his main goals should be to stop smoking. I wish you and your stepfather the best of luck.

    Posted by acampbell |
  9. I know that the following information may sound suspect. However, it is not meant to provide advice as opposed to sharing my particular experience.
    I developed a rash. My Doctor says its poison Ivy. However, the rash more resembles Scabies to me. The Doctor insisted that I needed steroids? for treatment and advised me that I would experience a rise in my blood sugar. As I am a type 2 diabetic, and someone, who at 70, should do a better job of controlling what I eat, etc, I don’t. The Doctor prescribed Prednisone (10mg), two tabs a day for four days,1 tab a day for four days, and 1/2 tab a day for four days.
    Well, my waking blood sugar used to be somewhere around 130-140. My daily, somewhere around 125 and after my sometimes loss of self control at dinner with friends, it gets into the 150’s. After two days on Prednisone, my waking blood sugar is about 120, just before lunch it was 92 and I felt like my blood sugar was going down and I had the shakes; however I was fine after a bowl of soup and an apple. Same thing on day three and four. (incidentally my rash has gotten worse) The Doctor also prescribed hydroxine 25mg for itching. It doesn’t do anything for itching but induces, in me, what I imagine a taking of to much cocaine would be like. lethargic, very, very drugged like, can’t concentrate, fall asleep every few minutes. ( I don’t take it anymore)
    My question is, is there any data on stroids helping type two diabetes? Incidentally, my feet don’t hurt anymore! Thanks for any input.

    Posted by Bruce Garwood |
  10. Hi Bruce,

    I’m not aware of data showing that taking steroids helps diabetes (meaning, that it lowers glucose levels). For most people with diabetes, taking steroids can raise glucose levels. You don’t mention if you take medicine to help control your diabetes; however, it may be that your pancreas is responding to the steroids by releasing more insulin. Generally, taking steroids for a short amount of time isn’t worrisome enough to be concerned about the effects on blood glucose. Hopefully your rash will clear up soon!

    Posted by acampbell |
  11. I have type 2. I have had a couple of steroid shots and a 6 pack of steroids for bronchitis. My blood sugar shot up to 230-250. I am through with the pills for a week now. I take Avandia. I just got a low number of 175 in the morning but the number sometimes goes back up to 230. I never had a problem controlling my numbers. I went back on a strict diet, but things are real slow coming around. Do you think they will start coming back down? How long do the steroids stay with you.

    Posted by B. Chiasson |
  12. Hi,

    Steroid injections can sometimes affect glucose levels up to 2–3 weeks later. Also, you’re recovering from bronchitis, plus the oral steroids. So I’d suggest perhaps waiting another week and continuing to check your glucose levels. You don’t mention what your glucose average was prior to the steroids, but if they haven’t come back down to “presteroid” levels after another week, give your physician or diabetes educator a call.

    Posted by acampbell |
  13. Hello,

    I have to take steroids for life [5mg daily] for chronic Sarcoidosis. I have been having symptoms such as shaking, feeling sick and hunger especially for something sweet, sometimes my blood shows raised sugar levels, other times its normal. My GP says the steroids are upsetting my sugar levels. How will this affect my body and organs?

    Posted by Cheryl |
  14. Hi Cheryl,

    Managing diabetes while taking steroids can be a little tricky, but its certainly possible. You don’t mention what kind of medicine you take for your diabetes, and you don’t mention how often your blood glucose is running on the high side. My advice is to ask your physician for a referral to a diabetes specialist (an endocrinologist) to evaluate your diabetes medicine program and maybe even switch your diabetes medicine. Also, don’t forget to focus on your carbohydrate intake. You don’t have to stop eating carbohydrate foods, but it’s helpful to try and eat about the same amount of carbohydrate at your meals on a day-to-day basis. Doing so can help lessen the fluctuations in your blood glucose. Meet with a dietitian if you’re not sure how much carbohydrate to aim for. Again, the overall goal (for most people) for diabetes is an A1C level of less than 7%. If you’re not at this target range (or whatever range you’ve decided upon with your doctor), it’s time to adjust your treatment plan.

    Posted by acampbell |
  15. Bruce Garwood,

    You and I are kidred spirits. I too am Type 2 and developed a rash(?). Having had my Grandson the day before, and my doctor not being in, I went to the ER to like you, make sure I didn’t have something contagious. They had no idea what the rash was? Three doctors looked at me and gave me no real diagnosis, except that I had a rash.

    Finally scratching there heads they sent me home with a little tube of antibotic cream, (which did nothing) and steriods. I forgot the name but it one that you take 5 the first day, 4 the next, and so on till done.

    Not only did I make them aware of my diabeties, I was already shaking because it was high. A few days later this rash (?)grew all over my body and I had welts, even in my hair. Four weeks later and having seen allergists, and dermatoligists, and through biopsy found I had an aggresive case of Psorisis and exama. I had no idea how painful this is. I’d never had any skin conditions and I’m 44.

    Riddle me this? How do two doctors send a diabetic home with steriods for an undisclosed condtion? And never did they mention and changes I might need to be aware of, being a diabetic. Not to menation, the fact that they couldn’t figure out or even consider psorisis now that I have learned more about it, it’s pretty common. I’m not a doctor and I wasn’t aware of this disease. What I have become aware of, is if you catch it early you can take steps to minimize the breakout hence pain. I’m considering taking further action.

    Just my story…;) Wish you all well

    Posted by Heidi |
  16. I have had diabetes for almost 20 years. I got is after (or during) my cancer treatment for lymphoma which included massive amounts of steroids and chemotherapy. I was initially treated with oral medications but I always had high blood sugar. About 8 years ago I switched to Lantus plus some orals but still had high blood sugar. Last year I had a mild heart attack and while in the hospital I was told I had to do something about the high blood sugar. I went to an endocrinologist and he said I actually had type 1 diabetes and put me on additional insulin (3 shots a day of novolog plus the Lantus at night.). Since then I have been having a lot of episodes of low blood sugar (some as low as 40) always about 2.5 hours after an insulin injection and particularly when I engage in any kind of physical exertion. This is an intolerable situation as I feel as though I am crippled. I have cut back the insulin severely and haven’t had a reaction for the last few days but I don’t know where to turn. I saw another endocrinologist and he said that since my hemoglobin A1C was 7.9 I was OK (it had been 8.4). Any suggestions? Jean

    Posted by jean |
  17. Hi Jean,

    Having frequent lows can certainly be debilitating. And it does sound like you need less NovoLog before your meals. My suggestion is to learn more about how much NovoLog you need at meal time by doing carbohydrate counting. It’s a more precise way of figuring out your insulin dose. You would use both an insulin-to-carbohydrate ratio and a correction factor (if your premeal BG is high). A dietitian can help you with this. You would also learn to decrease your insulin for physical activity. It sounds like you’re on the right track but need some fine-tuning. Also, the A1C goal for most people with diabetes is less than 7. Seven-point-nine is definitely better than 8.4, but it may still be too high for you, so perhaps discuss your goal with your endocrinologist.

    Posted by acampbell |
  18. My husband had an episode of asthma requiring about 6 weeks of Prednisone starting at 60 mg qid tapering. His blood sugar was arounf 150 at the highest. The doctor did an A1c a few weeks later which came back around 7. He put him on Metformin which he didn’t tolerate well. He is now on Actos with good readings. Is it possible that the A1c was elevated due to the steroids or is there a way to tell it is actually diabetes?

    Posted by Toni |
  19. Hi Toni,

    Yes, it’s possible that the prednisone caused an increase in A1C (because it lead to an increase in blood glucose). Remember that A1C is a reflection of blood glucose readings over the past 2–3 months. He should probably have a blood test for diabetes, but not while he is on prednisone.

    Posted by acampbell |
  20. I am a type 2 diabetic since 2008. I am currently on insulin and used to get by with only 16-25iu of inusulin per day…with morning blood sugar readings ranging from 135-165, HbA1c was 7.8. On 31 May 2010 I went to Dr because of a skin rash (similar to hives) and informed him that I was a diabetic and was on insulin.

    He gave me a huge cortisone injection in the buttocks and since then my BG control has been thrown out of the window. One week after teh injection I was getting readings of 253-386..two weeks after injection reading range from 163-256. I am in the fourth week now and still I dont have the control that I used to have.

    When will the cortisone effects dissappear? It’s very disheartening. My endocrinologist and educator were working so hard to possibly reduce or eliminate my need for insulin and only have me of metmorfin. Now I have to use 24iu of insulin twice a day and still that doesn’t always work.

    Frustrating! and Depressing!

    Posted by Gavin |
  21. Hi Gavin,

    Yup — steroids, while effective at doing what they’re supposed to do, have the unfortunate side effect of raising glucose levels. From what you mention, it sounds like you had a pretty large dose, so the effect on your glucose will probably last for at least several weeks. The good news, though, is that it looks like your glucose levels are coming down. You could consider also taking metformin, which helps reduce insulin resistance and help your insulin work a little better (but, of course, talk to your doctor about that). And don’t forget that physical activity and going easy on the high-carbohydrate foods may also help bring your blood glucose down.

    Posted by acampbell |
  22. Hi,

    I am not (haven’t been diagnosed)a diabetic. I recently took a steroid for 6 days; you know 6 then 5 then 4 and so on. I took the last one two days ago and today I noticed that my vision is blurry. I have a relative that lost her sight before her diagnosis so I bought a test kit and tested my level 2.5 hrs after lunch. It was 453!
    How long will a oral steroid remain in my system and keep my levels raised?
    If I need to be tested for diabeties do I have to wait for the steroid to pass through? I just don’t know what to do.

    Hope you have answers,
    Rachel

    Posted by Rachel |
  23. Hi Rachel,

    Did you check your blood glucose just one time with your meter or have you been checking more often and seeing high readings? If so, I’d advise you to call your doctor and let him know. Taking steroids can sometimes cause “steroid-induced diabetes,” which could go away soon after stopping the steroids. Also, consider any other diabetes risk factors that you may have, such as a family history of diabetes, a history of gestational diabetes, inactivity, and being of Hispanic, African-American, Asian American, or Pacific Islander ethnicity.

    Posted by acampbell |
  24. Hi:

    I had steroid injections in my C2and 3 plus C5 and 6, bilaterally today. My blood glucose levels usually run between 125 - 170 depending upon the time of day. They are now 340; the dr. said they would be high. I take 2000 units of Metformin a day. I plan to call my Primary Care Physician to see if he recommends more Metformin. The performing physcian said not to increase the dosage. Any thoughts for me?

    Posted by renae |
  25. Hi renae,

    I agree with you that you should call your primary-care doctor. It’s hard to say how high your blood glucose levels will go, and for how long they’ll stay high. You’re already on close to the maximum dose of metformin. Sometimes, when people get steroid injections, doctors will prescribe a fast-acting insulin to be used temporarily to help keep glucose levels under control. But check with your doctor and find out what he or she would suggest.

    Posted by acampbell |
  26. Hi,i never had problem with diabetes but my mother and sister had it, igot bit by a ant big toe was sollowen part of my feet, went to the er they give me a steroid medrol dosepack. my family doctor said that my a1c was a 7 is it possible that the a1c was elevated beccause of the steroid plus he said my feet would go down in a day or tow been on the metformin hcl 500 mg for 2 week feet still the same. Any advise for me.

    Posted by justin |
  27. Hi justin,

    It’s doubtful that your A1C of 7 is due to the steroid. Given that your mother and sister had diabetes, there’s a chance that you may have diabetes as well (it runs in families). My advice is to first, call your doctor about your feet and let him know that they are still swollen. Then, ask your doctor to check you for diabetes. our doctor likely did the right thing by starting you on metformin, which is a very good medicine for diabetes. But you should find out for sure if you have diabetes.

    Posted by acampbell |
  28. I have had a injection in my lower back for a bulgded disc. My levels have gone up 200%, I take oral meds only for my diabetes and nothing seems to get it down, it’s been over 2 weeks.

    Before the shot I was really careful on what I eat and my levels every day in the a.m. were normal, sometimes a little too low.

    Posted by Ed Hill |
  29. Hi Ed,

    I’d suggest you give your doctor a call, especially since your glucose readings have been high for so long. You may need a larger dose of your pills or even some fast-acting insulin, temporarily.

    Posted by acampbell |
  30. My husband had a steroid injection for his hip
    Mon. morning (this is Wed. nite) and his blood sugar numbers have gone to 241,297,274, 240 and now up to 363. Should we be alarmed? We know steroid makes the numbers higher but the 363 seems very high. Any suggestions? He is on 20 units of Lantus and takes Glimepiride morning and nite. Thanks.

    Posted by M.J.Buckley |
  31. Hi M.J.,

    If your husband’s blood glucose has not come down today, I’d recommend that he call his physician. He may need more diabetes medicine (temporarily) to bring his readings down.

    Posted by acampbell |
  32. My mother-in-law was just diagnosed with pulmonary fibrosis after a stay in the hospital with pneumonia. She has had diabetes for years controlled with medication. I know just in treating the pneumonia her sugar went sky high and she needed insulin and now has been uncontrolled. Are steroids the only treatment for fibrosis? Would she have to be constantly monitored in a hospital if it causes her sugar to increase so high? She does not even know how severe the fibrosis is yet but I am wondering if this medication is even an option for her.

    Posted by Melanie |
  33. Hi Melanie,

    I honestly don’t know much about pulmonary fibrosis. I do know that steroids are a common treatment. And it’s not uncommon for people with diabetes who take steroids for various reasons to have high blood glucose. Keep in mind that your mother-in-law’s blood glucose can be controlled with insulin. Her fibrosis is likely more of a concern and treatment options are probably limited. She may need to go on insulin to control her blood glucose, but this can be done in an outpatient setting. It can seem scary at first to have to go on insulin but it’s actually the most effective medicine there is for treating diabetes. I’d suggest that she ask her primary-care physician for a referral to an endocrinologist and diabetes educator to help her get regulated on insulin and learn about other lifestyle measures to help her better manage her diabetes.

    Posted by acampbell |
  34. My Father in law is 91 and a type 2 diabetic has been on oral meds only for 20 years. BG levels never higher than 150. He was recently hospitalized with bronchitis and on IV steroids and tapered on oral steroids. He is now on insulin. BG is coming down but wondering if there is a chance that he may now always require insulin injections? Could this episode trigger the need for daily insulin even when the steroids wear off? He would not be capable of giving himself those injections so I am wondering if I should start looking into other arrangements for his continued care.

    Posted by Mary |
  35. Im a type 2 diabetic and not on any medication as of now, will be shortly. I also have ITP which they are treating me with steriods. My problem is they told me I would be jumping off the wall, But I’m not. I’m very tired and have no engry. I can get through my work, but when I get home I have to sleep. Why am I not jumping off the walls.

    Posted by judy |
  36. Hi Mary,

    It’s a little hard to say if your father-in-law will continue to need insulin. Most people can go back to their usual form of diabetes treatment. The good news is that his blood sugars are coming down, so there’s definitely a chance that he can come off of insulin as long as his blood sugars get back under control and as long as his bronchitis is resolved. You may have to play it by ear in terms of what he will need longer-term. I’m sorry, I wish I could be of more help!

    Posted by acampbell |
  37. Hi Judy,

    People can react differently to different medicines. You may just have a different reaction to the steroids, which is perfectly normal. However, if you’re concerned about it, ask your pharmacist or give your doctor a call.

    Posted by acampbell |
  38. Hi, I had a intra-articular Depo-Medrol 80 mg shot yesterday. Normally my glucose in in the 80-100 range, 2 hr. pp less than 140. Today my lowest reading was 185 and the highest 386. I feel crappy to say the least. My normal meds are glucophage 1000mg. But today I’m trying to cover the highs with insulin. How aggressive can I be and not have to worry about lows? How long will this Depo-Medrol mess with my glucose. Steriods are evil!

    Posted by AMorrow |
  39. Hi AMorrow,

    Steroids can certainly be frustrating to take when you have diabetes. The effect of steroid injections can last up to several weeks in some people. I’m assuming (and hoping) that whoever prescribed you the insulin gave you some guidance as to how much to take and how to increase it, as needed. It’s important to have a plan (often called a sick-day plan) when you take insulin so that you have direction as to how much to take and how to advance it and taper it, too. Talk to your doctor if this is not the case. The best way for you to know how your insulin is working and whether you need to increase or decrease it is to check your blood glucose at least four times a day, maybe more. As the days go by, you may need to taper the insulin dose, too. Be on the safe side and make sure you have treatments for low blood glucose with you at all times, such as glucose tablets, glucose gel, or juice.

    Posted by acampbell |
  40. I have had diabetes for 46 years - Can I meet acampbell - I think if I knew him/her I would be much better than I am now !!!!

    Posted by Susan Gail |
  41. My mothers blood glucose has been low, ranging from 54 to 75. She went to the doctor yesterday, and he gave her injections in both knees for arithritis. He also gave her cymbalta…and she’s also on celebrex. Today her blood glucose went from 154 to 175 this evening. If it continues to get higher what can she do?

    Posted by Judy Fletcher |
  42. Hi Judy,

    I’m assuming that your mother was given steroid injections in her knees, which is likely what is increasing her blood glucose. This effect will likely be temporary as the medicine will wear off. You don’t mention if your mother takes any medicine for her diabetes, but I would suggest that if her blood glucose levels rise above 200 to call her doctor. She may need a temporary increase in her diabetes medicine dose. And, she should check her blood glucose perhaps more often than she usually does, such as 3–4 times each day.

    Posted by acampbell |
  43. I have type 2 diabetes. 9 yrs. diagnosed. My sugars always ran high because honestly I didn’t like the medication. In April of this year I started have thigh muscle pain in my left leg. Lots of tests showed nothing wrong. EMG/nerve conductive showed no neuropathy. I lost 45 pds. Laid around with heating pad and didn’t want to eat. Lowe back started acting up. L3,4,5 and S1 are bulging with a little arthritis according to MRI. 4 months later right leg wants to act up but not as bad as left leg. My A1c In April was a 9. After several months of not eating what I normally did because of no appetite my A1c dropped to a 5. Sugars are running 111, 130 and sometimes higher depending on what I eat. I am supposed to start pain clinic and I know they will want to do injections. I am scared to death. I have been on oxazepam for 15 years for anxiety and panic and it worked well for me til all of this started. Now anxieties have hit the roof. I worry about how much it will effect my BG now and my anxiety. Started off with thigh pain and then lower back.

    Posted by Georgia |
  44. I guess I never thought leg pain could start before actual back pain especially the front thigh muscle. The idea of injections just scares me really bad.

    Posted by Georgia |
  45. Hi Georgia,

    I’m sorry to hear of the pain you’ve been having. But the good news is that you’ll be going to the pain clinic where they are trained to provide you with help and relief. Be sure to let them know of your fear of injections (which is common) ,as they likely are familiar with this and can help you deal with them. Good luck!

    Posted by acampbell |
  46. Thanks for the reply. I guess what confuses me is that can leg pain start first and then almost 2 months later lower back pain starts? I always thought back pain was first then maybe leg pain.

    Posted by Georgia |
  47. It is like something is just playing on every nerve in my body. I was told if there were any signs of MD, ALS or anything like that the EMG and nerve conductive study would have picked it up even if it was early stages. Had lots of bloodwork to. Full body bone scan with spect. Everything comes back fine. Drives me nuts not having a diagnosis.

    Posted by Georgia |
  48. I recently had a FBS that was 156. I subsequently had an A1c that is 6.5. Based on these values my Dr started me on Metformin.I did not have a glucose tolerance test.
    I have had a cortisone injection (three weeks ago) and have been taking Simvastatin for several years, both drugs that can cause elevation of blood glucose.He is prescribing Lipitor in place of the simvastatin.
    I had hoped to try to lower my values with diet and exercise before starting on meds for diabetes. I am not due for another Cortisone injection (arthritis) until Feb.
    Is it reasonable to wait until Feb when another A1c is scheduled to start taking the metformin and checking my sugar?

    Posted by Larry |
  49. Hi Larry,

    It sounds like your doctor started you on metformin, but then you mentioned that you’re hoping to wait until February to take it, so I’m not clear if you’re actually taking it now or not. According to the ADA Standards of Care, one way that diabetes is diagnosed is by an A1C of 6.5 or higher. And, typically, for Type 2 diabetes, the first line of treatment is metformin. It could be reasonable to try diet and exercise alone, given that February is 4 months away. However, the issue is your recent cortisone injection and how that currently is affecting your blood glucose, and if so, for how long. If your blood glucose levels are running high from the cortisone, it may be wise to take the metformin. I’d also suggest asking your doctor if he thinks it’s reasonable to hold off until February.

    Posted by acampbell |
  50. The common cold & asthma landed me in the hospital for the 2nd time in 7 months. In April I was in for 7 days on large doses of steriods, including Decatron IVs 3x daily. My blood sugar was never tested. Both parents are diabetic and I check weekly & am starting to see higher readings (120 in the am).
    Now I’m back in the hospital just 24 hrs and had 60mg of prednisone in the ER, dou-neb treatments every 4 hours, am back on the Decatron IVs plus Singulair & Zithromax. My breathing is much better already but my blood sugar is testing at 226, 201, 275 & now 296! Not sure why this Dr is checking the numbers & I’m glad he is being proactive but I’m afraid he wont release me just because of the bg numbers. If I stop the Decatron IVs, how soon will my body go back to its normal numbers (my suspision is I am pre-diabetic as I am obese)? Could my previous unchecked visit & treatment had predisposed me to steroid induced diabetes a bit early? Last week I had a comfortable 90 reading 2 hrs after dinner. The drs here want me to take insulin but I’m resisting hoping getting off the steroids will alleviate the problem. Am I wrong?

    Posted by Susan |
  51. Hi Susan,

    Glad to hear that your breathing has improved! IV steroids may not be much fun for you, but they’re obviously effective in helping to treat your asthma. Unfortunately, for some people, high blood glucose levels are a side effect. \Most hospitals are very aggressive in treating hyperglycemia in all of their patients (with and without diabetes), as hyperglycemia is linked to increased risk of infection, other illnesses, longer hospital stays and increased costs. So, you should actually thank your doctor for being on top of things and you should seriously consider taking insulin, at least while you’re in the hospital. It may take 4 to 5 days for your glucose levels to go back to “normal” after the IV steroids are stopped. However, I’d suggest you follow up with your primary-care doctor and get checked for diabetes or prediabetes, given your family history. Good luck!

    Posted by acampbell |
  52. My daughter was diagnosed with type 1 diabetes at the age of 11 - 1 1/2 years ago. Her numbers have never been in range for more than 1 or 2 meter readings. She was also diagnosed with Bronco Malasia, a lung defect and has been on a preventative steroid, flovent which she takes daily as well as albuterol. I have heard that steroids can affect her blood levels. She seems to be having highs in the am when she wakes up. She needs to take both of these at night and in the am. Could this be a reason for her having so many highs?

    Thanks

    Posted by krobbins |
  53. Hi krobbins,

    It’s certainly possible that her lung medicine is causing some insulin resistance, which results in higher blood glucose readings. Also, your daughter is entering puberty, and that in and of itself can lead to swings in blood glucose due to fluctuation hormone levels. In addition, she could be making food choices that are causing increases in her blood glucose. First, make sure that her morning high blood glucose readings aren’t a result of her going low in the middle of the night. Second, talk to her pediatrician or diabetes educator about increasing her insulin doses. If she’s running high most of the time, she needs more insulin. It also wouldn’t hurt to have a review of her eating plan with a dietitian, too!

    Posted by acampbell |
  54. Hi Amy,
    I read Diabetes Self-managemant and would like to know if there are any recents articles on diabetes and steroid injections. I had my first injection for neck pain on 1/11/12 and my blood sugrs levels shot up to over 350 in the evening and remained high all night even though I took more insulin and ate less. I plan to have at least one more injection, but these high levels have me concerned. I plan to call my docotor today
    but would like to know what advice you may have.

    Thank You

    Posted by Charles Hayden |
  55. Hi Charles,

    I don’t have any recent articles on diabetes and steroid injections at my fingertips. However, I suspect that the advice remains the same: You need more insulin, temporarily, until the effects of the steroid wear off, which may take a couple of weeks or so. You didn’t mention how much more insulin you took, but let your doctor know the dose so that he or she can help you determine how much more you actually need. And check your blood glucose more often than you usually do, so that you can see how the increased dose is working.

    Posted by acampbell |
  56. Last 3- weeks my sugar level remains 325-395.I take for that 10mg Glipizide xl twice a day and one tablet Januvia-I was on it for last 4 days.

    I was out of country for 6-7 weeks to go to India.
    Is there may be a infection or virus?
    Do i need to take any test like Expiloris.

    I ate many times out in the restaurants.

    Please guide me .

    Thanks

    Posted by Jay |
  57. Hi Jay,

    You would likely know if you had an infection or virus. But it’s a good idea to call your doctor and let him or her know that your blood glucose levels have been running in the 300’s (I’m assuming that they usually are not this high and that you were taking your diabetes medicine while you were away). You likely need an adjustment in your diabetes medicines. And, of course, if you aren’t feeling well, you should call your doctor, as well.

    Posted by acampbell |
  58. My wife is on chemotherapy, and has been diagnosed B cell lymphoma, CD-20 diffusely positive.tHE DRUG FOR CHEMO lS MEBTHRA, and steroids, She is Diabetic, and was taking tablets and now has been put on Insulin , morning evening 10 Units, my worry is monitoring, pl tell if it is a right soloution.

    Posted by Azam |
  59. Hi Azam,

    Your wife likely needs insulin at this time due to the effect of her chemo drug and the steroids. Her taking insulin is not a bad thing, as she needs to keep her blood glucose levels in a safe range, particularly when she has other health issues. And she should be checking her blood glucose with a meter so that her physician can adjust the insulin doses, as needed. Her physician may have suggested how often she should check her blood glucose, but if not, I’d suggest, for now, checking at least 2–3 times each day: first thing in the morning before breakfast, before lunch or dinner, and again before she goes to bed. She may need to check more often, depending on how her blood glucose levels are running (for example, if she is having high or low blood sugars).

    Posted by acampbell |
  60. Hi Im 29 weeks pregnant and a type 1 diabetic for 16 years. I have been told today that i need steroid injections to help develop my babys lungs as i have preeclampsia and they need to deliver my baby soon. I don’t want to go on a sliding scale but the doctors say i might have to. Im a daphe trained diabetic and want to control my insulin myself any advice on keeping my levels low.

    Posted by Marilyn price |
  61. Hi Marilyn,

    I’m not quite sure what you mean by “daphne trained” but what I would suggest is to meet with a dietitian who specializes in diabetes to learn carbohydrate counting, using an insulin-to-carohydrateb ratio. A sliding scale is based on the premise that you eat a consistent amount of carbohdyrate at each of your meals, every day, and you adjust your insulin using your scale based on your premeal blood glucose. Using an insulin-to-carbohydrate ratio and a correction factor gives you more flexibility and control.

    Posted by acampbell |
  62. My question is in regards to my 9 yr ol Rottie that was just diagnosed with diabetes. She also has Addison’s disease. The med that she takes for the Addison’s is Flurocortisone which is the generic form of Florinef. I’m learning that steroids cause problems for diabetics, making it very difficult to regulate the glucose levels. problem is, the Addison’s medication contains steroids. Any suggestions? Thanks for your help

    Posted by terri deal |
  63. Hi terri,

    OK, I’m assuming your “Rottie” is your dog! Both her Addison’s and her diabetes need to be treated. You’re correct in that the steroid that she takes for Addison’s will very likely aggravate her blood glucose control. However, dogs with diabetes do take insulin, just as humans do, so you should talk with your vet about the best treatment approach should be. It may be that her meals need to be spaced out a little differently, for example, or that she receive insulin injections twice a day. If she’s overweight, helping her to reach a healthy weight (with the right amount and type of food, plus regular physical activity) will be important, too.

    Posted by acampbell |
  64. Hi,

    Ten days ago I had a Laminectomy, and as part of the post-surgery treatmeant the doctor gave me:

    1. Ultracet
    2. Baclofen
    3. Neurontin
    4. Cipro and
    5. Medrol

    A few days after I started using them, I felt very weak, dizzy, my pressure went down (98/55) and my blood pressure went hi (222). When I called my Neurosurgeon he told me to stop them because it was too much. I knew before his instructions that I couldn’t stop Medrol, but because I was 2 days away from finishing, I stop using it.

    It has been 3 days since I stop medications, I’m eating healthy, drinking a lot of water and eating every 2-3 hours but I still feel the same. My questions are:

    - Could I develop diabetes from those medications, specially, Medrol?
    - If they knew I hypoglycemic, Medrol was the right option?

    Anticipated thanks,
    Mari Tere Espada

    Posted by Mari Tere |
  65. Hi Mari Tere,

    Medrol is a steroid medication, which means it can raise blood glucose levels and possibly lead to steroid-induced diabetes. Given that your blood glucose went up to 222, you’re right to be concerned. It’s not a good idea to suddenly stop taking steroids, however. But since you’ve already stopped taking the Medrol, I’d suggest you schedule an appointment with your primary-care provider to get checked for diabetes. Medrol and other steroids are powerful but effective medications. Even though they can cause serious side effects, sometimes it’s necessary that you take them, and your surgeon was likely following a protocol to make sure that you recovered properly from your procedure.

    Posted by acampbell |
  66. i have been given a course of prednisolone 5mg 6 a day for 10 days i am insulin dependant 3 times a day and 2 levermer morning and night my readings have been sky high 29 at one point had to go and fet keytones checked ok but was advised to cut out carbs i have not been told to cut down slowly should i or just stop after the course how long will thy stay in my system

    Posted by lesley |
  67. i am in the uk by the way

    Posted by lesley |
  68. Hi lesley,

    My suggestion would NOT be to stop eating carbohydrate. You need the nutrients that they provide, and cutting them out completely while taking insulin could put you at risk for hypoglycemia (low blood glucose). You could certainly cut back on your carb intake, but you should also ask your doctor or diabetes educator about adjusting your meal-time insulin so that your blood glucose readings are not too high. Fortunately, you’re only on this medicine for a short while. The effects may last for a few weeks after you take the last dose.

    Posted by acampbell |
  69. Amy has excellent advice. My experience has been that there are drugs - antibiotics and others that will cause the liver to really boom out the glucose and require assistance and Doctors help/advice to control better during these times.

    Posted by jim snell |
  70. I am type 2 diabetic. Due to an accident I have an injury to my neck and shoulder. I refuse to take narcotics and my ortho. has tried different meds to help with the pain. Ultimately I need surgery. I currently take Neurontin. I was taking Naprolen but found it caused swelling in my ankles. The pain got so bad that I had 3 cortisone Injections in the areas last Thursday. I knew about how my BS would react and I have a scale I follow for Novolog injections. However, a new problem has come up. Two days after the injections I started vaginal spotting which has become a mild period. My last period was in August 2009. Could this be caused by the injections? I had colo-rectal surgery In Sept. 09 for a flat polyp that turned out to be cancerous and followed up with 12 treatments of chemo. My oncologist said all my follow ups have been clear since. Any advice would be helpful.

    Posted by H.D.Gilbert |
  71. Hi H.D.,

    I’m afraid I don’t know enough about steroid injections to give you an answer. I’d suggest that you first ask your pharmacist, and then, let your oncologist know about your spotting as this should be looked into sooner rather than later.

    Posted by acampbell |
  72. I found out I have pneumonia and the doctor gave me a shot of steroid and a shot of antibiotic. Then was give the four pack of steroid and some pill form of antibiotic. I did not eat anything but toast that morning and cucumbers around 1pm. and came home after dr and my sugar was 180. Then at 12am I check my sugar, I ate at 9pm, after eating some spaghetti and a couple of snack size candy bars at8pm. My sugar was 353. My sugar level has nevery been that high. Is it because of the steroid shot. So that means I need to look closer at my levels during the dayand watch what I eat while I am on the meds?

    Posted by Marsena |
  73. Hi Marsena,

    Yes, your blood glucose is likely high from both the pneumonia and the steroids. This is common. However, I’d advise you to do the following: check your blood glucose levels more often than you usually do (ideally, a few times a day); make sure you eat but go easy on high-carb foods like pasta, rice, bread (watch your portions of these); call your doctor if your blood glucose levels continue to be high. You don’t mention if you take medication for your diabetes, but sometimes, when on a steroid, people either need to start one (temporarily) or increase the dose.

    Posted by acampbell |
  74. Had chest pains and ER doctor took all heart tests needed and x-rays and determined I had an inflamation of the chest covering of my lungs. My Primary cam in ER and thought I had pluresy. Maybe the same thing? I’m a diabetic II and they gave me a steriod shot and inflammitary drugs to take. My blood sugar was 325 when I got home and I’m sweating awfully. I take Onglyza daily and Prandin at meals. What else can I do to lower my blood sugars. I ate only soup when I got home from the ER and drank lots of fluids. I have some metaformin given to me to try but I get severe diarrhea, but should I take it anyway is it better than the Onglyza or should I take both a while. I feel really bad.

    Posted by pacockren |
  75. Hi pacockren,

    It’s pretty common for blood glucose levels to go up, often quite high, after receiving a steroid injection. Your blood glucose should come back down but it may take several days, maybe more. In the meantime, rather than trying to adjust your medication on your own, please call your doctor’s office today and let them know that you don’t feel well because your blood glucose is very high. Your doctor can prescribe the right type and amount of medicine for you.

    Posted by acampbell |
  76. Hi i have type 1 diabetes and asthma, this is a lethal combination as i am on a course of steroids due to my breathing problems at the moment. My sugars are so high my blood meter will not give me a reading it says its Hi so it is always a worry for me. I have increased by insulin but it doesnt seem enough.

    Posted by Cheryl |
  77. Hi Cheryl,

    Please call your physician, endocrinologist, or diabetes educator (whomever helps you with your insulin doses). You obviously need a larger increase in your insulin doses but you should have some guidance for how to best increase them.

    Posted by acampbell |
  78. Hi: I am an insulin dependent diabetic have been for 65 years. I had a pneumonia vaccine shot yesterday. My blood sugars have been very high today. I am on a pump and have been injecting a lot of insulin today. Will the pneumonia vaccine cause this high blood sugar. I haven’t eaten anything out of the ordinary - usual eating habits today. Sugars average 6.1/day usually. Today they averaged 13. Too high!

    Posted by vicki skulsky |
  79. Hi vicki,

    I’m not aware of the pneumonia vaccine causing high blood glucose, but it’s quite possible. However, you should consider other possibilities, too, such as a pump malfunction, a blockage in or a disconnect of your infusion set, old or expired insulin, or an infection at your infusion site. Check for ketones and continue to give yourself insulin boosters, but if your high blood glucose levels persist, call your health-care provider.

    Posted by acampbell |
  80. Just reading the posts and was interested by the one from marilyn and although it was january and I am sure she has had her baby just thought would post a response!
    For ladies with type 1 and like her carbohydrate counting (dafne), then managing the rise caused by the steroids is relatively easy to do.
    testing more frequently ie between meals they can then give correction doses of quick acting insulin, which they should know specific to their regime. They may need to increase their background insulin also which is easily identified as they would be testing so frequently.

    Posted by chandler |
  81. type 2 diabetic for about 20yrs. Am getting a steroid injection for back pain. I called my primary care who is my diabetic coach and she says not to worry the numbers will come down. I take metformin twice a day glipizide twice a day and insulin 10 u twice a day and only know that my sugar will increase with the steroid shot but won’t know till I get the shot. I am very anxious about this all. Does the sugar rise right away and can I bring the numbers down with high protein and low carbs and increased insulin?

    Posted by Bethel |
  82. Hi Bethel,

    It’s understandable that you’re feeling anxious about the steroid injection, and you’re wise to be thinking ahead. My advice, though, is to have the injection, check your blood glucose levels frequently, and if you start to see them climb (which they likely will), call your doctor for guidance on adjusting your medication. The effects from the injection can last a while, so you don’t want to have constantly high blood glucose levels. Treat this like you would treat a sick day: many people with diabetes do need to take additional medication when they are ill, and having a steroid injection is no different. You can also cut back somewhat on your carbohydrate intake, although don’t cut it out completely. Be firm and persistent with your doctor about this, but first, wait and see how the steroid affects you.

    Posted by acampbell |
  83. Am so greatful to all that have contributed here will like to know if there is any complication in diabetic pateint that can lead to decrease in blood sugar like anaemic patient not havin malaria n cystic fibrosis not having tyhoid.will always love to how glutathione can be replenished in diabetics and also drugs that can be used to conter the effect of prednisolone in diabetics

    Posted by lilygurl |
  84. Hi,

    I have diabetes 2 and have sciatica and the Pain management Doctor will have to inject Meds in my back or spine. I am not sure this will effect my diabetes. 000The pain pills have no effect anymore. So the next step is injections. I am told this presurge will be in a hospital. I guess like a uperdurial. Excuse my spelling. Please answer soon. I am taking Janumet and Levimir insulin, 42 twice a day. My sugar is in control now.
    Thank you,

    Paulette M.

    Posted by p monsivais |
  85. Hi Paulette,

    If your back injection contains a steroid (and it very likely will), expect your blood glucose levels to increase for about 2–3 weeks afterwards. Check your blood glucose several times a day during this time, and if you see that your glucose levels are rising, call your doctor. You may need to take a meal-time (fast-acting) insulin, like Humalog, NovoLog, or Apidra, temporarily during this time to help lower your blood glucose.

    Posted by acampbell |
  86. Hello, I had a blood test a week ago , and today my family doctor had call and said that I was a diabete. My A1-c was 10.6. He thought that it could be from the prednisone that I have taken for years 5mg every other day. But for the last year I have been on 5mg every day and some days I will take two 5mgs (I have RA }My Reheumatologist has been giving me steroid shots once a month for the last 6 months Celestone Depo Medral. I have been in a lot of pain.So do you think this could cause my blood glucose to be so high ? He wants me too come back next week. If I stop the shots and come off of prednisone well it come down? How long do you think it will take ? I just started on Arava last week.
    Thank You

    Posted by Kathy G |
  87. Hi Kathy G,

    It’s hard for me to know if coming off the prednisone and the steroid shots would help to “normalize” your blood glucose. My thoughts are that your A1C of 10.6 is quite high and needs to be treated at this time, even if you were to come off of your steroid medication in the future. Please talk to your doctor about the best course of treatment for your “diabetes.” It’s possible that you may need to start on insulin, given your A1C level. It’s also a good idea for you to start checking your blood glucose levels with a meter. Ask your doctor to refer you to a diabetes educator or a diabetes program in your community.

    Posted by acampbell |
  88. I’m type 2 diabetes. Insulin depend since. 2008. I have had multiple problems. My latest is. Inability to. Stand or sit. From a. Bone fragment in my spine. At. L2 L3. Level. I am having the steroid shots. I try to make sure my pre. /surgical. BS. Is. Normal. My spike seems to come about 4 to 5 hours after the injections. I. Take 70\30. Insulin. My range is. 500 after surgery or up. I. Check my. Sugars. Every.2-4hours
    And. Use a titrated dose. In between my regular doses of insulin. This seem to keep me more level. So. If it’s 4 hours after my regular dose. I. Take. 1/4. Of my regular dose
    And recheck. If it’s still extremely high. I take. 1/4. Of my regular dose again.in 4 hours. This seems to bring me down from the high 500-600 range. To. The. 175 to 275 range.
    It dosesnt seem to last more than 2-3 days.

    Posted by Donna harris |
  89. I am a type 2 diabetic on Lantus 25units twice a day and Humalog adjusted as to my carb intake (4units/10grm carb). I have bursitus and archilles tendinitis. Yesterday I had a steroid injection into my heel. Pain seems a little better. My BSL was fine for a few hours but when I checked it going to sleep it was 22!! I took Humalog and stayed awake a few hrs and rechecked BSL before sleeping - was 18!! Took more humalog and set alarm to wake me 3 hrs later - only down to 15. More Humalog and took a 500mg Metformin (my usual daily dose). Was wondering if it is time to increase my Lantus dose and if so to how much? Was thinking 30units BD??? After reading above posts I have figured this is going to take a few weeks to settle down. Am I doing the right thing so far regarding altering Lantus and giving more Humolog?? Or should I contact my GP? Thanks
    Vicki

    Posted by Vicki |
  90. Hi Vicki,

    As you are finding out, steroid injections can cause a significant increase in blood glucose levels and a need for higher insulin doses. Humalog is the insulin that is usually adjusted for steroid use and that’s because it’s works quickly to lower the blood glucose and is out of the system by about five hours. Lantus, or long-acting insulin, is usually not increased because it works over 24 hours and does not bring the blood glucose down quickly enough and then can’t be adjusted again for 24 hours. Talk to your GP about adjusting your Humalog dosing during this time and check your blood glucose at least four times per day, before meals and at bedtime. The effect of the steroid usually lasts about two to three weeks. Initially you will need higher doses of Humalog to get the blood glucose levels down, but gradually these doses will go down as the steroid gets out of your system. Checking three hours after the additional Humalog is the right thing to do. If you find that the doses are not bringing your blood glucose levels down enough call your GP to see if another adjustment is needed.

    Posted by acampbell |
  91. Been a juvenile diabetic since age 12. 60 now. On Humalog and Humulin insulins two times daily. Humalog 12 units and Humulin 10 units. Was given shot of cortisone on right hip 29 April. Am also practicing Bikram Hot Yoga 5 times a week. Noticed that 2 weeks after the cortisone shot in the muscle my blood sugars went drastically low. On Wed I got confused as driving and when traffic light red stopped and decided not to move when came green in spite of cars honking. Paramedics called. 3 days later as driving noticed same confusion so stopped driving and but side swapped parked car. Also realized after several major sugeries each time upset sugars DROP drastically. I know yoga works every muscle down to the cellular level and so I will give up driving until 1 month later. I test blood sugars a lot and NEVER high. Forgot to mention given cortisone on hip on account of bursitis. Pain is gone now but must admit that I NEVER noticed blood sugars rise on account of this cortisone shot. Please advise me. Thank you. Helena

    Posted by Helena |
  92. Hi Helena,

    While it’s common for blood glucose levels to rise after surgery, stress and cortisone shots, it’s important to realize that everyone is different. You’ve learned how YOU respond to these various factors which means that you need to be checking your blood glucose more often (which you have been doing) and very likely cutting back on your insulin doses. My main suggestion for you is to make sure that your doctor/endocrinologist knows that this has been happening, and also that you’re prepared (as much as you can be) to learn how to adjust your insulin accordingly.

    Posted by acampbell |
  93. Lots of interesting information. I’m learning a lot. These high numbers people mention, 200, 356, etc., are these BS levels American? The AIc’s mentioned 6.7, 7.8, etc, are like Canadian numbers I’m used to. I think American numbers would be divided by 18???
    I’ve developed Graves Disease and along with serious eye problems. It’s been suggested I take 5099 mg of steriods (via infusion) for five days. Has anyone out there taken this amount… if so what were results on BS. I am Type 1 diabetic.

    Posted by Rose |
  94. Hi Rose,

    Yes, in general, when you see blood glucose numbers of 200 or 356, these are in mg/dl, which is the unit used in the US. To convert glucose values in mg/dl to mmol/l, you would divide by 18. For example, 200 mg/dl divided by 18 = 11.1 mmol/l. A1C values are written as a percentage in the US, such as 7.5%. It may be written as mmol/mol in other countries. As far as your possible steroid infusion, it’s best to be prepared knowing that it will likely raise your blood glucose levels. Plan on checking your blood glucose levels at least several times a day, and make sure you have a plan for how you might increase your insulin should you see that your glucose levels are rising.

    Posted by acampbell |
  95. I am still EXTREMELY UPSET with how my blood sugars dropped drastically 2 weeks after my cortisone shot of repo-medrol 80mg on 30 April and I wasn’t told to watch it. It was only on 26 May, almost 1 month after the shot was given that I was once again able to recognize that my blood sugar was dropping. Also, when I was my regular doc about this she agreed that yes, 2 weeks later it can drop. Yet when I went to see her one week later to get her to fill out forms from motor vehicles with regards to my ability to drive she told me a different story. She said cortisone makes the blood sugar go up and I need to see a diabetic specialist to get this resolved and in the meantime I should not drive and she is getting motor vehicles to take my licence away.
    This is affecting me mentally and emotionally drastically. It doesn’t matter that I can once tell when my blood sugars are dropping and I’m testing so frequently. I cannot accept this any more. I need help coping with this mental anguish she has created in my life.

    Posted by Helena |
  96. I am back and realize I forgot to mention several people are telling me my doc is actually ‘passing the buck” which I’m told means she doesn’t want to be held responsible. This is why she wants me to see the specialist.
    After being an insulin dependent for some 50 years I have realize a long time ago that docs are really great with theory. They don’t have to cope with this condition the way I do. A few docs have actually told me this.
    Take for example the time I went for my second breast cancer operation. The first one was in 2004. The right breast was removed including some lymph nodes and all this was accomplished in only 6 hours. It amazed the surgeons. This is because practice Bikram hot yoga and exercise and eat healthy. When cancer came back 5 years I went through a second operation and realized that each time I am upset my blood sugar drops and this went on all the time. Each time I posed this question to the diabetic specialist he ignored it. I finally stopped asking. Now, after this cortisone injection 30 April and after what happened 15th and 17th May this problem seems to have disappeared.
    What has happened to me may not be happening to other diabetics. It has happened to ME. PLEASE HELP ME COPE. Thank you

    Posted by Helena |
  97. Hi Helena,

    I am sorry that you’ve had to go through this. I can certainly understand how upsetting all this has been for you. You may want to consider seeing a diabetes specialist, or at least another physician to help you with this matter. I’m not sure that being on a steroid medicine warrants taking your license away. People who take insulin and who are at risk for low blood glucose levels are able to drive, but they are encouraged to check their blood glucose before they do so. It seems like you need another medical opinion to help you sort this out.

    Posted by acampbell |
  98. I know about type 2 part and everything. My husband has it for the last 12yrs. I just need some advice. Our primary doctorfor the last 7 months has really been neglecting my husband. We have been going to this doctor for 12yrs. He takes the pills and now the insulin as well. Anyway about 23 yrs he had major back surgery cause a transmission where he was working at him and four other guys was pulling out of a car, well it slip, three guys slpit and the transmission landed on his shoulders so he is it down all by himself, did walk out of there that day and never went back to that job. The next morning he woke up and couldn’t move, ambulane was called, doctors gave him 50/50 chance of ever walking again. They had to take bone stuff he said graph whever and fix his back. Out of his pelvic bone part. Sorry for mispell I have lupus, brainfog, anyway our doctor for the last 12yrs has alway rx him his pain meds and his other stuff ok. Well now since january she refuses to rx him no more pain meds and he was only getting once a month anyway. Also he had a truck accident in 2011 and totalled his truck but never went to the hospital to get treatment for it, anyway jjan, and march was the last time she rx him his pain med. And she chewed him out in march for bringing it back to her cause he couldn’t get if filled anywhere in our county and he asked her if she either would lower the doses or change it to a different pain med, she flew off the handle at him, told him that’s all he came in her office for and that she is going refer him to a pain management clinic, I know what pain management clinics do, they only give u steroids shots. He can’t take steroids shots!!!!!!!!! We’ve already told her that, been telling her that for years, so we have been back to see her since then. Anyway. He slipped and fell two weeks ago in my kitchen. I’m taking him today in another county that’s a drive about and hour an half away cause I can’t see my husband go thru this pain anymore. His sugar levels has raised up to 600. Its up and down between 300 to 600 since she has been neglecting him. Do u think I have a case, and do u think I need to seek a very good lawyer to sue her, yeah I know get my second opinions gets evidence. But do u think she being negligence tho… I am going to persue this no matter what. He is 59yrs old. I have been with him for 20yrs.. let me know what u think. Thanks in florida. Angela.

    Posted by angela roark |
  99. Hi angela,

    I’m sorry that you and your husband have had to go through all of this. I’m not sure I’m the best person to advise you in this matter. Getting second opinion is important. Also, a pain management clinic might be helpful for your husband as long as someone is carefully managing his diabetes. This is where a team approach comes in. Talk with another doctor, and it certainly can’t hurt to discuss the situation with a lawyer, if you truly feel that your husband’s doctor has been negligent. Best of luck!

    Posted by acampbell |
  100. Hello,
    Last year, August time-frame, I was diagnosed with diabetes. But not on any medication.
    About four months later, I was informed that I no longer had diabetes (normal A1C @ 6).
    However, the scare made me check my BC often in the mornings - which were stayed around 98 - 112.

    However, four days ago I received a Cortisone shot in my shoulder to reduce the swelling around my Rotator Cuff.

    Because I was feeling a bit ill, I checked my BC last night and was shock to see it at 189, and this morning was spiked at 146… After eating two hours ago - my levels are at 230…

    I am hoping everything returns to normal soon. My question is how long does the high symptoms last, and is it normal to have the spikes?

    Posted by JaiJ |
  101. Hi JaiJ,

    Diabetes, once diagnosed, usually doesn’t just go away, but it can certainly be well-managed. At the very least, an A1C of 6 puts you in the “prediabetes” category. Given that, it’s not necessarily surprising that your blood glucose went up after the cortisone shot. It may take a week or so for your BG levels to return back to a safe range. I’d advise you to have your A1C checked to find out if you possibly have diabetes at this time.

    Posted by acampbell |
  102. Just wanted to thank you. I saw when you posted this, and that you are still responding to comments. After doing a search for high blood sugar, in response to a cortisone injection, this was far and away the most helpful page.

    I’m a self diagnosed Type 2. I first checked my sugars just for fitness, and noticed how high my sugar levels get after high carb meals, and both my parents are type 2. I thought because I was so fit, diabetes would not be a problem. Wrong.

    I’m able to control my sugar levels by monitoring my carb intake… Except a cortisone shot left it in the 200+ range, hours after eating.

    This page, and your responses have really helped me.

    Thanks!

    Posted by Troy |
  103. Hi Troy,

    I’m very glad to learn that this site has been helpful to you. That’s the goal!

    Posted by acampbell |
  104. I have had type 2 diabetes for ten-ish years (don’t remember exactly). My A1Cs have ranged from 5-ish to high 6’s and I felt good taking Janumet. Last autumn I was diagnosed with breast cancer. I had a lumpectomy, six weeks of radiation and started on aromasin (a hormone blocker) last April. Aromasin is a steroid compound but nobody mentioned to me that it might make my sugars go high. Blood glucose readings were getting in the 400 to 550 range so my doctor added byetta and then insulin to the Janumet. It brought the sugars down to 300 to 450 range. The diabetes educator in his office has me increasing insulin daily with the goal to get my sugars below 125. I have four injections daily and they hurt. The insulin and byetta are very expensive. I’d like to drop the aromasin but doing so would increase the possibility of a recurrence of my cancer. Nobody — not the oncologist or my primary care doc — mentioned or took into account that aromasin and diabetes are poor mates. I’m supposed to take the aromasin for at least two years, possibly as long as four years. I don’t know what to do.

    Posted by Carolyn |
  105. Hi Carolyn,

    The unfortunate side effects of some medicines is high blood glucose, as you’ve been experiencing. The Byetta is probably not helping you enough at this point; you may benefit from taking both meal-time and basal, or long-acting, insulin. Another option to consider is to use a mixed insulin (which is a combination of short and long-acting insulins), and this type of insulin is injected twice a day. Talk to your doctor and your diabetes educator about your options.

    Posted by acampbell |
  106. Hi, i have had well controlled Type 1 diabetes for 20 years. I recently found out i was pregnant. However, it also looks as though i am being diagnosed with vasculitis and lupus. Rheumatologist wants to put me on low dose steroids and continue them for as long as possible, if not the whole pregnancy. Is it possible to maintain tight glucose control whilst on steroids?? I’m nervous, but know that untreated inflammation is dangerous too. Please help!

    Posted by kate |
  107. Hi kate,

    Please talk with your endocrinologist and OB/GYN. You’ll need careful monitoring by your health-care team, and you’ll need to carefully control your carbohydrate intake and monitor your blood glucose levels very closely. Hopefully, if the steroids are low dose, as you say, it will be doable! But make sure you voice your concerns with your team and that you have a plan in place for follow up.

    Posted by acampbell |
  108. Hi. I am pre-diabetic and not currently on any medication. A few months ago, I went to a dietician class and was given a blood glucose monitor and my doctor said I only need to check it once a day. I check it in the morning. My blood sugar has usually ranged from 90-120. Yesterday I had a steroid injection in my knee for osteoarthritis. This morning my blood sugar was 163. I checked it about 45 minutes later before eating and it was 150. Then after eating, it was 210 and 218. I feel a little dizzy and last night woke up sweating. Should I be alarmed with these blood sugar numbers or just wait the 2 days-2 weeks for the steroid to wear off and just monitor my blood sugar? At what blood sugar level should I go to my primary physician? Again, I am currently not on any medication. I was not advised that my blood sugar would rise with the injection or I would have declined it. Also, since my blood sugar is high, will this affect the 3 month test I will be having soon? Thanks!

    Posted by Sharon |
  109. Hi Sharon,

    You may want to wait a little while (say, a few weeks) and see if the effects of the steroid injection wears off. You can always let your doctor know, but he or she will likely tell you to wait a bit. You might hold off on getting your three-month test (A1C) as your higher glucose readings will most likely impact it. It may be best to wait until the effects of the injection have worn off.

    Posted by acampbell |
  110. I am Type 2 Diabetic for several years now and I started off with oral diabetes meds. Now I am still taking Metformin 1,000mg twice day and I am also taking two different type of insulin, which are 20 unit of Novolog (aspart) with every meals and 55 units of Lantus (glargine) at night before I go to bed… Last month my A1c was like 6.0, normally my daily reading are between 110mg/dL to 140mg/dL. I was doing okay and I’ve manage to control my blood glucose until last week when I went to see a Podiatrist to have my foot exam and the Dr. gave me two shots of steroids in my heels. However, that night when I went to check my blood glucose my reading was 307mg/dL and that scare the heck out of me. So, what I did was I took 1/2 unit(10 unit) of Novolog and call one of the Dr. at the ER to double check if what I did was ok and he told it was and he told me to call him back in a hour, which I did and my reading was down to 300mg/dL. Then the Dr. gave me the go ahead to take my 55 unit of Lantus, but I continue to check my glucose afterward to make sure it was going down slowly and not rapidly and causing me low glucose reading again. I did had a low blood glucose reading before too, which went down to 60 mg/dL, that also was scary and I had to hurry drink some orange juice, which took a little longer to raise my glucose. I went to visit my Dr. the next morning and told him what I went through for my low glucose reading and he prescribes a Oral Glucose Gel call Glutose15 which works fast. Glutose15 contain 40% dextrose (d-glucose)the kind of sugar your body most readily absorbs. Other kinds of sugar found in candy and commercial food product may take longer to work because it takes time for them to break down in your digestive system. So when I go places I make sure I have me a tube of Glutose15 on me for emergency and my insulin. I do agree it gets frustrated when you get all these side-effects unexpectedly and just need to continue to monitor your glucose when you get injected with steroid. Just like to share my experience with you and wish all of you well…

    Posted by Wes |
  111. I have been on steroids for about 8 months, I am also on lots of other tablets fo heart failure and heart disease, and they are treating me for sarcoid I’m under a Professor Wells, who cannot do biopsies as my heart won’t be strong enough.
    Since I have been on the steroids I am now a diabetic,I was wandering if when I come off the the steroids will I still be a diabetic?
    Warm regards
    Marion Lloyd

    Posted by Marion Lloyd |
  112. Right now I am furious. My husband evidently has chronic bronchitis. He was put in the hospital because he needed iv meds. He now has steroid induced diabetes and the doctor sent him home (not any better) with yet another prescription for a steroid. All the years he has been treating him for this, he has never told us the danger of getting diabetes nor has he done any blood tests to see if all these steroids were affecting his pancreas. My is now taking 3 shots a day of insulin. I am so frustrated I could scream!!!

    Posted by Virginia Lloyd |
  113. I am having a lot of back pain due to a pulled muscle, can I take Celebrex I am type 2 diabetic and am just on tablets and diet to control it.

    Posted by Gary |
  114. I was on meds for diabetes for a while and was able to go off due to extremely careful eating, etc. I got my A1c to between 5.7 and 6.1. My glucose readings were 104-110 in AM, usually 95-115 before lunch and dinner, 150-170 2 hrs after eating, and 100-130 at bedtime. Unfortunately I needed a cortisone shot in my knee 2 days ago and am getting readings still at 170 and 160 4 and 5 hours after dinner. I know it has only been a day or so, but how long do these higher readings keep up? My plan for tomorrow is to go as carb-free as possible to hopefully help the situation. I was so proud of the good work I had done controlling and am afraid to see it ruined.

    Posted by Kathy |
  115. Hi Kathy,

    The blood sugar effects of a cortisone shot may last for a week or even up to several weeks. Your blood sugar readings after dinner aren’t all that high, so I don’t think you should worry too much unless your levels go higher or, if after a week, they aren’t dropping. Then give your doctor a call. I wouldn’t advise cutting out all carbs, because that means you won’t be getting the energy and nutrition that you need (it’s still important to think about your overall health, too). Are you able to do physical activity? If so, try to focus on doing some exercise, perhaps even a few times a day, as long as you get your doctor’s OK.

    Posted by acampbell |
  116. Hi Gary,

    I’m not a pharmacist, but from what I’ve read, I don’t believe Celebrex has a major effect on blood glucose levels. However, this is a good question to ask your pharmacist.

    Posted by acampbell |
  117. I am a type 2diabetic. I also have 3 fractured disc in my spine. I have been being treated with steroid injection, in my spine. Before the injections, I was keeping my weight, around 160. Today at the doctor. I had gained 20 lbs.
    I am very interested in the new medicine, Invokanna. Butmy insurance Medicare and Medicaid, will not pay for it. Any ideas on how or who would help me pay for this med. Because I am scheduled, for more steroid injections, and do not want to gain more weight.

    Posted by Robin Barden |
  118. Hi Robin,

    It’s certainly frustrating when your health plan doesn’t cover medicines that could be helpful to you. You can try a few things: First, talk with your doctor about Invokana and why you think you would benefit from being on it. If he agrees that this drug would help you, ask him to document, in your medical record, your previous and current diabetes treatments so that there is a clear record of what you’ve tried. Then, ask your doctor to fill out a prior authorization form. This can take a lot of work to complete, so stay on top of your doctor and his office staff to make sure that the paperwork gets completed. If the request is denied, you can appeal the decision. Finally, visit Invokana’s website and contact their patient assistance program. They may be able to help you. If these steps don’t work, talk with your doctor about other types of diabetes medicines that are more “weight-friendly.” Keep in mind, too, that medicines are just a part of weight management; don’t overlook the importance of an eating and exercise plan to help you lose weight. Medicare will cover the services of a dietitian and you may be eligible to work with an exercise physiologist or physical therapist to help you with an exercise program that’s safe for you.

    Posted by acampbell |
  119. I was hypothetically wondering what the effects of anabolic steroids would be on a type one Diabetic. I do not personally use those drugs, but there are a few really big guys at my gym that I think might be on it and after reading this helpful forum, I got curious about those effects.
    Thanks!

    Posted by Garrett |
  120. Hi Garrett,

    Anabolic steroids are essentially man-made versions of male sex hormones. Some athletes and fitness enthusiasts take them to build muscle and enhance performance. They can cause very serious side effects, such as high blood pressure, heart attack, liver and kidney damage, and breast growth and testicle shrinkage in men. Anabolic steroids may cause insulin resistance, which, in turn, can lead to high or uncontrolled blood sugar levels. It’s not worth the health risk of taking anabolic steroids. On the other hand, there are men who are low or deficient in testosterone, for example, and they certainly can benefit from hormone replacement under a doctor’s supervision.

    Posted by acampbell |
  121. Hi my.name is suhas my age is 26 i am suffering from diabetes recently my sugar level is 376 before fasting in morning and 556 after eating i am.unable to control my bg level from last 2 years i.tried many doctor but doesn’t get any improvement so kindly help.me my body wight is looseearly i am 70 kg now i.am.just 40kg i am consuming steroid previously decca for many years i.want to removed daibetes from life permanently so.kindly help.me i..staying in navi.mumbai i went to mysore for an job within.just one months i fall sick and loat mt weight so i.came in mumbai than got admitted so doctor tell.me you have daibetes as i guess it ia because of steroid i cosumes so.now i am.so.weak so kindly help.me please

    Posted by suhas more |

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