Steroids and Diabetes

Steroids are synthetic hormones that work by decreasing inflammation. Diabetics may need steroid drugs to treat potential coexisting ailments like asthma, autoimmune diseases, arthritis, and dermatitis, or as part of chemotherapy (to relieve associated pain, inflammation, or nausea).

Depending on the medical treatment, these steroids might be administered as an oral pill, tablet, a liquid/cream solution, nasal inhaler, injection, or intravenous therapy (IV). However, does the use of steroids and diabetes management go without complications? This and many other questions are attended to in this article.

Benefits of Steroids for Diabetics

Let's have a glance at why people with diabetes seek the use of steroids.

Reduces Inflammation

Many diabetic complications, such as cardiovascular and renal disease, are caused by chronic inflammation. When inflammation affects vital body organs, steroids can save the organs and, in many cases, save lives.

For example, steroids may prevent the escalation of renal inflammation—which could lead to kidney failure—in vasculitis or lupus patients. Moreover, steroid medication may eliminate the need for kidney dialysis or transplantation in these patients.

It also prevents rheumatoid arthritis (RA). This is particularly beneficial as studies prove that having rheumatoid arthritis (RA) raises your risk of developing type 2 diabetes by 50%. Notably, low steroid doses may offer considerable relief from pain and stiffness, while short-term usage of larger steroid doses may aid recovery from a severe arthritic flare-up.

Prevents Muscle Loss

Diabetes is linked to several health issues, including a loss of skeletal muscle mass. Furthermore, the loss of muscle mass has been associated with all-cause mortality, and controlling it can enhance therapy outcomes and lengthen life expectancy.

Thankfully, steroids can be used to help prevent muscle loss, although this is less common. While using steroids isn't the only way to sustain muscle mass, it may present considerable benefits. Nonetheless, potential adverse effects like mood changes, sleeping difficulties, and an excessively high appetite must be considered.

Surprisingly, one 2017 study on mice proved that while weekly administration of steroids promotes muscle repair, daily dosing yielded contradicting results — increased muscle wasting. Although no human trials verify this claim, it could serve as a pointer for an improved steroid dosing regimen.

Risks of Steroids Usage for Diabetes

The use of steroids in diabetes doesn’t go without complications. That said, let’s examine the significant ill effects that accompany the use of these medications in diabetic patients.

Weight Gain

Steroids have an impact on metabolism and how fat is stored in the body. Notably, this can cause increased hunger, resulting in weight gain and, more specifically, excess fat deposits in your abdomen.

Weight increase makes blood sugar regulation significantly more difficult for type 2 diabetes patients. Hence, if you’re taking steroids, it’s advised you track your calorie intake and exercise more often to cut down on excessive weight.

Disrupts Heart Function

Research published on JAMA Network shows that steroids usage can result in dangerously low blood pressure levels. Namely, the extended use of systemic steroids can cause a suppression of adrenal cortisol production — a steroid hormone that regulates blood pressure. This is a minus for diabetics because cardiovascular disorders are a significant risk factor for diabetes.

Furthermore, scientific reports link the use of anabolic-androgenic steroids (AAS) with coronary atherosclerotic plaque and a compromised heart pumping. The former results in a limited supply of blood to the heart's muscles, causing an increased risk of heart attack, ischemia, and ultimately, heart failure.

Causes Insulin Insensitivity

A Diabetes Care paper proves the long-term use of low-dose prednisolone (a steroid medication) can impair hepatic insulin sensitivity. Namely, it promotes insulin resistance and causes a decline in peripheral non-oxidative glucose disposal. In simpler terms, chronic steroid users are very likely to experience elevated blood sugar levels over time.

Should You Avoid Taking Steroids if You Have Diabetes?

If you are diabetic and can’t avoid steroid use, your best bet would be to consult your doctor. This could influence their judgment on which anti-diabetic medication to co-administer. In cases where you can't avoid steroid intake, adjusting its dosage is an option. However, this is still left to your doctor’s discretion.

Additionally, there are several measures you can employ to manage your condition if you're combining the intake of steroids and diabetes management. They include the following:

• Monitor your blood sugar levels more frequently—at least four times daily.
• You can take higher doses of your insulin/anti-diabetic medication dosage judging by your blood glucose readings and your doctor's advice.
• Keep a close eye on your blood or urine ketone content.
• In cases of excessively high blood sugar levels despite adequate diabetes medication intake, see your doctor right away.
• Keep juice, candy, or glucose pills handy if you experience a sudden decline in blood sugar levels.