Q: I have well-managed type 1 diabetes. I’ll be getting a steroid injection and heard that it could really mess with my blood sugar control. What can I expect? And more importantly, what can I do about it?
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A: You heard right. For anyone with diabetes (and even those without diabetes), injections of steroids such as cortisone can cause significant insulin resistance that can last for a week or more. For someone like yourself who has type 1 diabetes, that can produce very high glucose levels. The same thing can happen when taking oral steroids such as prednisone or inhaled corticosteroids.
While it is always important for people with diabetes to manage their glucose levels, it is even more critical to keep blood sugars in check when recovering from an illness or injury. High glucose levels can interfere with the healing process and contribute to longer recovery times and an increased risk of infection.
In most cases, steroid medications take at least a few hours to start affecting glucose levels. Depending on the type and dose of the steroid, the effects tend to peak in one to three days and then taper off. Those who don’t usually take insulin for their diabetes may require insulin injections for a short while after receiving a steroid. For those who already take insulin, the dose of basal insulin may need to be adjusted for several days. Additional doses of rapid-acting insulin may also be required to bring any elevated glucose readings down to normal. Talk with your physician or diabetes care team prior to receiving your steroid injection to work up a game plan.
Want to learn more about steroids and diabetes? Read “The Link Between Prednisone and Diabetes” and “Diabetes and Steroids: Can People With Diabetes Take These Medicines?”
