Prednisone making sugar high


How Prednisone Affects Blood Sugar.
I t isn’t unusual for people with diabetes to sometimes require corticosteroid treatment. Corticosteroids, or steroids for short, are used to reduce inflammation and suppress the immune system. They are often a last resort for a wide variety of conditions, in everything from asthma to allergy attacks to arthritis and ulcerative colitis. Steroids are also prescribed to prevent the immune system from seeing donated organs as foreign bodies and rejecting them after an organ transplant. One of the most commonly used steroids is prednisone.
“Among all medications available to treat different medical conditions, prednisone and similar steroids have the most profound effect on glucose metabolism. Medications such as prednisone can significantly increase glucose levels in patients with diabetes as well as individuals with impaired glucose tolerance or pre-diabetes,” says William Sullivan, M.D., a senior staff physician at Joslin Clinic in Boston and the Medical Director at the Joslin Clinic at Beth Israel Deaconess Hospital, Needham.
Prednisone is amazingly effective at calming inflamed tissue and reducing pain, but that comfort sometimes comes at a high price. Prednisone’s list of side effects is long and scary. The longer you are on the drug and the higher the dose, the more likely it is that you will experience side effects. When you have diabetes, even a short course of prednisone at a low dose is likely to wreak havoc with your blood glucose levels. In fact, another name for corticosteroids is glucocorticoids in honor of the powerful effect they have on glucose metabolism.
Prednisone induces elevated glucose levels by stimulating glucose secretion by the liver as well as reducing glucose transport into adipose and muscle cells. The overall effect is a reduction in glucose clearance. Elevated glucose levels can lead to glucose toxicity further impairing insulin secretion. Prednisone can also impair GLUT-2 expression. GlUT-2 is a protein mediated glucose transporter that ferries glucose across cell membranes. That means that people with diabetes taking prednisone are likely to see a significant bump in their blood glucose numbers depending on the dose of steroid given.
One of the most difficult things about taking prednisone is that it doesn’t elevate glucose readings consistently throughout the day. Prednisone taken in the morning usually doesn’t cause glucose levels to start to rise until lunch time. Blood glucose readings usually stay high through the early evening hours and then decline over night. Many people have normal or low glucose readings in the morning while taking prednisone.
This type of action curve can make it difficult to use flat basal insulin such as Lantus® or Levemir ®to treat people taking prednisone. Sometimes the use of NPH can be helpful for people on prednisone as it has a peak mid-afternoon and if given in the morning its effects taper off toward the evening, mirroring the action of the prednisone. When using NPH the overall effect is a better balance between your glucose levels and your insulin throughout the day.
The good news about prednisone is that it is cleared from the system fairly rapidly and once you stop taking it, blood glucose levels return to normal fairly rapidly.
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What about prednisone shots? I have had shots for bursitus and the effect of prednisone lasts several weeks. My endocrinologist recommended a 25% increase in my basal (I am on a pump). Any thoughts?
The response to steriod injections is very individual. High blood glucose levels can be maintained for a few days up to a few weeks. Therefore, it is important to monitor your blood glucose response after an injection and report persistent high numbers to your health care provider.
what about those who take steroids for ulcerative colitis flare up and are already pre-diabetic, will they become diabetic and why isn’t this ever told to people as a possibility?
Dear Ms. McGinnis:
Many people who take steroids for ulcerative colitis take them episodically. It is likely that your blood glucose will rise during the time you take the steroids, but will return to baseline after the flair is over. If the rise in blood glucose during the flair is significant your health care provider may suggest a medication to treat it.
UC patient does not need to take steroid relapsed UC. Now I am steroid resistant. I am suffering from UC for last 14 years. My UC was relapsed for 5 time till date. I experienced a lot of problem on oral and systemic Steroids. During last relapse I detected a herb and compound it hygienic way. I took it for 7 fays only. Now I am OK on Tab Mesacol.
I’ve just been diagnosed as pre diabetic.
I’m not overweight at all, I exercise, eat pretty well.
I have had so much trouble with my UC, that I’ve been on pred for maybe 2 years. I’m down to 9mg. But I’m worried.
What can we use other than prednisone?
I had colitis for many years.
Only one thing that worked. Diet! I have not had a flare up in over 35 years.
No yeast like bread.
No dairy of any type.
It is a candida diet.
If you can find a good herbalist, that will help you jump start the process.
Couple of questions: How do you recommend getting other specialty physicians to work with my endocrinologist when steroids are necessary? It seems like all physicians think they can handle my type 1 when I am seeing them for surgery or whatever, but they really cannot. Hospitals are even worse. Also, recently went thru 6 months of chemo where it seems that incuding a steroid in the chemical mix to prevent some side effects is standard. That happened to me once before I refused the steroids. It was not pretty! Is there some alternative to use or is one type of steroid less harmful than others? I’ve had a tough time with this all my life. Even though each physician is great individually, they dot seem to play well with each other for the benefit of the patient.
what about people who are on pred for long periods of time for bad diseases?
my little dog has gme, a terrible autoimmune disease of the central nervous system.
pred is the most effective remedy to keep gme attacks at bay; however jake has been on it for 3 months and it has given him steroid induced diabetes. his sugar was initially in the 600s and is still quite high as we are only ramping down the pred now.
does going to a low, every other day dose of pred, allow normal insulin and blood sugar metabolism to return, even somewhat? i imagine the answer would be much the same for mammals other than people, so an insight into how such situations effect people would help me and jake.
I’m not sure how old this post is, but for anyone reading, for cats (need prednisone instead of prednisone) and dogs, starting off at twice a day, the tapering to once a day, then every other day, and then decreasing the dose to the minimum effective dose will decrease side effects. It’s important that it’s every other day. There will be fewer side effects with a higher dose given every 48 hours than a lower dose being give more frequently. So the pet might need more pred per day on average at 48h dosing intervals than daily dosing. It’s the 48 hour break between doses that’s important.
Just had biometric screening for work. Glucose levels were 141 after fasting 10 hrs. Had a heavy dose of cortisone injections in my right foot previous afternoon. Never had high level before, no diabetes in family history. Could this injection have contributed?
I’m having significant swelling in my foot after a bee sting. I’m on prednisone, amoxicillin, and mortin. The swelling as gotten better over the last two days and I move my toes now. I have been having morning normal BS 125-135 reading but daily reading of 250-400. I normally workout at night, but haven’t for the past three nights. Would prednisone effect me working out by going too low, or would you recommend not exercising until off of the prednisone in another 6 days?
Thanks for your question. Due to the medical nature of your question, we recommend you post it on the Joslin Discussion Boards, which you can find here:
I have been on 40mg prednisone for 6 months and am now just tapering off. I am wondering what tests I should ask for to make sure I don’t have glucose problems due to being on prednisone for so long, and when would be the best time to take these tests? After I have stopped the prednisone or now?
Thanks for your question. Due to the medical nature of your question, we recommend you post it on the Joslin Discussion Boards, which you can find here:
I was om 80 mg now tapering 10 per week. My blood glucose has been in the 280s to 380s. Does this mean I am diabetic? I didn’t feel any symptoms until now, that I am prednisone. My doctor wants me to take an ac-1 test, won’t that be in accurate cause I am still on prednisone?
Thanks for your question. Due to the medical nature of your question, we recommend you post it on the Joslin Discussion Boards, which you can find here:
I am a Type 1 Diabetic of 25+ years taking a daily regimine of 28 units Lantus and Novolog, sliding scale, insulins and currently in my second day of a six day course of Prednisone, in addition to Keflex, prescribed for treating a particularly stubborn sinus infection. I’ve had consistently high BSL’s since starting the Prednisone. 300+ readings. No matter how much fast acting insulin I take, my BSL remains uncomfortably high. My question; are there general guidelines of how many units to increase bolus doses of Novolog to compensate for the Prednisone induced hyperglycemia? My concern is overdosing the Novolog and bottoming out my BSL. Thanks for reading my question.
Thanks for your question. Due to the medical nature of your question, we recommend you post it on the Joslin Discussion Boards, which you can find here:
My experience of 30mg for 6 days, is double lunch&nearly evening insulin.
I’m takeing 100 mg of predosone in the early am I’m diabetic my numbers are usually 130 to 170 after I take the 100 mg my level in about 7 hours goes up between 500 and600 I’m a pill diabetic when it goes to 500 I take 10 units of insulin and it takes 6 hours to bring it down to200 not happy with those numbers but I only take the 100mg for 4days to help reduce the mass in my abdomem from lypphoma.
I’m diabetic and have had a steroid dexamethasone shot and 5 additional pills to take 1 per day since Xmas eve. This was for extreme rotator cuff tendonitis pain. It is working but the glucose has been consistently between 273-430. I’m trying to avoid going to ER(again) for an IV. Wanted to know if I increase my reg. doses of glyberide 2.5 , and metformin 500 ER tabs to metformin 850MG (not extended release from a previous prescription long ago) , would it be alright on my liver. I would be OK on the glucose going lower and be able to handle it not dropping too low. Im just concerned about the length of time my levels are so high and also if the temporary change in med would be more harmful to liver. (I did stretch out my steroid pill doses because of the elevation) I have 1 more dose to take tomorrow. Having a hard time getting through to doc. during holiday season. I’m trying to complete the steroids.
I was prescribed the steroid at the ER not the IV. I was referred to go back to ER for an IV if levels didn’t come down. I do have ins. But lots of extra money still involved and Doc’s office doesn’t do IVs.
I am concerned that a lot of people are paying a very high price trying to get the help they need. I know that it is said that a lot of research goes into medication before being released for public consumption but at what cost to some? I know that a lot of us need help but I don’t think the time to disclose harmful side effects are after the facts.
I am just a little disappointed because my husband almost died from 2 doses of doxycycline. His tongue sword while he was asleep and he was put in an induced coma. Also, a shot of prednisone is taking his blood sugar on a high and it is not coming down. I would that there had been more disclosure before hand.
I appreciate all the medical help. I believe most Doctors mean well.
I have been weaned from pred for two weeks. My glucose levels are getting better but not where they need to be. Could the pred still be in my system adversely affecting my blood sugar?
Thanks for your question. Due to the medical nature of your question, we recommend you post it on the Joslin Discussion Boards, monitored by Joslin health care providers and educators, which you can find here:
Poison ivy so bad can’t see had a shot for hit nothing type 2 diab gave me prednisone for it have diabetes for 32 years no medication nothing control with what I eat so if diabetes goes up 1 point I can fell it.
Type 2 diabetic controlled with diet, I have contact dermititus and the Doctor’s assistant put me on prednizone 3 pills 10 mg 7 days 2 pills second week 1 pill third week. I have seen my test strip numbers go to 200 _ 250 with 192 this morning. Will these numbers create long term issues and should I stop using the prednizone or continue for the duration?
I have type 2 Idiabetes I also have asthma I need to take some steroids by mouth sometimes from my asthma i wonder if it will Raise my blood sugar.
Yes, it will raise your blood sugar levels/readings. You should work with your Primary Doctor, or Endocrinologist, to plan how to counteract the Prednisone effects. I have the same asthma situation with Prednisone prescribed for it. Every time, it has the same side effect. You also need (to have) a kit to test your BSLs during Prednisone treatment..
I have been a type 2 diabetic for a decade. I find it easiest to only use Novolog. Not the pen, but with old fashioned shots as needed. I have done a very good job of keeping my average blood sugars at 121. Then I was told to take a powerful steroid as a precautionary med for an MRI, for possible contrast dye reactions. I was only prescribed 2-3 days of this steroid (Methlyprednisolone 32 mg) Almost INSTANTLY my blood sugar more than doubled. Novolog became useless! it was as if I became immune to insulin. (EXAMPLE)…..Six hours ago I was at 265, so I shot 10 units of Novolog and ATE NOTHING! Normally this would get me down to the 100-140 range, upon awakening. This time I somehow went UP, to 282. My primary dr. told me not to worry & that it will leave my system soon & everything will be back to normal. All I know is that, I don’t feel safe & can’t relax when I am near 300!
My husband type 2 diabetic and is hospitalized for shortness of breath. He went for all the test, but not told what causes the shortness of breath. Can he take prednisone tablets to help with the breathing? Is it safe to take?
I have the opposite reaction to steroids. I was diagnosed last year with diabetes with at 6.7 A1C, and after Metformin and Actos treatment, my A1C is down to 6.1. I have a history of insulin resistance, gaining middle-body obesity as a young child, and developing Polycystic Ovarian Syndrome as an adult. I was able to become pregnant at age 35 after 5 years of infertility simply by taking Avandia for 6 months. So, obviously, insulin resistance is an underlying factor in the development of my Type-II Diabetes at the age of 45. In the past 6 months, I have needed to take three courses of prednisone–once in January for Asthma with 40mg and ramping down over 10 days, once in March with 60 mg for a Reactive Arthritis flare-up (I have been diagnosed with Diffuse Idiopathic Skeletal Hyperostosis, which is strongly correlated with insulin resistance, early middle-body obesity, and diabetes), and most recently with a spinal injection at the site of severe lumbar spinal stenosis caused by the DISH. Could my diabetic/insulin resistant condition be related to cellular inflammation, and thus, when steroids hit my system, my cells are more amenable to receiving insulin? If so, how do I fix this? Thank you in advance for your response.
My Dad is type 2 diabetic and after taking prednisone 20 mg for about 4 weeks we are noticing his blood sugar is consistently staying low and we think he needs less insulin. Could this because with his inflammation being cleared up, his pancreas is working to produce more insulin?
I posted the original comment over a year ago, and I have still found that cortisone reduces my blood sugars. I am more convinced than ever that diabetes Type II is not one single illness, but symptomatic of many different pathologies. My pancreas shows signs of chronic inflammation, and is now mildly atrophied, and I have a genetic marker for biliary duct autoimmune illness. I believe that my diabetes is caused by this autoimmune illness, and that treating the autoimmune problem would reverse my diabetes. But doctors don’t believe me, or dismiss me. It’s sooooo frustrating.
I was on intravenous prednisone for an allergic reaction to the drug SOVALDI. I was on IV for 3 days and released home with a 6_5_4_3_2_1 titration, each pill was 10 mg prednisone. I have been TOTALLY OFF of prednisone for since Saturday 15th of August 2015. Today is august 25, 2015 and my blood sugar levels run from a low of 429 to a high of 700+.
My doctors are no longer answering my questions and keep changing the subject.
I feel as if I am dying. Should I be worried?
What about Vistamethasone eye drops how does it affect diabetics, in terms of glycemic control? Can it even be used in diabetics for catarract treatment?
i have been on stroids for 2 weeks i am on insulin and my sugar counts r very how they climb after breakfast to about 28 and i have 1 weet bis and i yoghurt when i am high before , i eat lunch , how much should i take before i have one sandwich for lunch and i eat a small tea of chicken and veges at tea time and im still very high about 25 going to bedl please i need help thanks.
i was put on prednisone for 5 days at 50mg a day. on the forth day i saw a significant spike in my glucose. At about 12 noon it was 502 and dropped to 315 by 210 pm. my vision became somewhat blurred and has gotten a little better but is still fuzzy. how long should it take for my vision to clear up?
I started on 80 mg Of prednisone in 2010 i went down to 20 two years ago And i cant go down anymore. If i go down 15or 10 i get soo sick. Im taking prednisone to treat and control The syndrome Of Churg Strauss And alergies. Lately i have been Having low blood sugar in The 60’s i felt tired, shaky, nervousness, sweetness and fatigued(weaken) inpatient, I could not think clearly.
I asked the nursed from my work to test my blood and it was in the 60’s. How can I low my doses of prednisone ? I made an appointment with a doctor to tell her about my condition. I have been on prednisone for 6 years every day. And still have shortness of breath and all this new symptoms. I want to get off of it but idk how and idk if it is possible. When I try to go down I ended up very very sick with cough pneumonia and shortness of breath. I guess all these are side effects of prednisone.
I am 58 years old not diabetic, since last 6 months having Hair dye reaction, so taking Prednisolone , of & on with tapering dose, now it is 5 mg daily with 80 mg prednisolone depo injection, I have Hb1c test & fasting test.
This hb1c is due to Cortisone usage or advise.
I have a possible diagnosis of temporal arteritis . They have me on 60mg of Prednisone to start. Until they can confirm my diagnosis, biopsy of temporal artery. If I indeed have TA, I may have to be on steroids for up to 2 years. I am a type 1 diabetic with a pump. I am terrified to possibly be on a steroids for this long. I have doubled my Basel rates and the increase my Bolus rate is incredible. I believe my insulin sensitivity is bad while taking steroids. Has anyone with type 1 ever had any experience with this diagnosis.
I just found out I have arterisrlte, they tell me if I don’t take prednisone I can have a stroke, this medication is driving my sugar blood very high I’m doing a low sugar diet as if I’m diabetic but doesn’t work all the time I don’t know what to do, is this the only medication in the market for it.
I don’t understand what you are asking for.
I want to know what to do to control the high sugar blood and if there is any other medication to control my illness.
You don’t understand my question?
I am female. After my first pregnancy 45 years ago, my hormones became imbalanced registering too high on testosterone. My endocrinologist prescribed daily prednisone. He lowered and lowered dosage with monitoring down to 5 mg daily. He told me the prednisone affects the pituitary gland, and it should never be stopped. Over the 45 years, I have asked 3 different endocrinologists to stop it and monitor me. None will take it on. I am now diagnosed prediabetic. After reading this article, I wonder am I destined to become a Type II diabetic? Please advise.
I had a shot of prednisone yesterda afternoon in my knee. My glucose shoot up to 2000. Been drinking water but I can not walk it out. I am pre-diabetic and I usually controll it wirh food. It is now 11:00pm Im very hungry but afraid to eat. I have metformin at home but this late at nigh Im afraid to take it.
I am Type 2 diabetic that just had my A1C reported at 6.1. My normal fast numbers are around 95-110. I Avery rarely have any reading over 130. I take one Metfrmin 500mg per day and the rest is diet.
I just started therapy for breast cancer with an infusion every thre weeks for a year. There is a steroid treatment of oral Dexamethasone for the 3 days around the infusion. 1 pill twice daily before the treatment and 1 pill twice daily for the day of the treatment and the next day. (4mg each). So a total of 24mg for each session. What I need to find out is what was in the IV during the infusion as they may have meant me to wait until the day after for the next round. At any rate…my fasting blood sugar was 200 this morning and I have 2 more steroid pills to take today. I will call the doctor today…but probably think I will have to increase the Metformin during the sessions and watch if the blood sugars return to normal in a few days.
I’m type 2 diabetic on metformin an lantex insulin had copd an couldn’t breathe emergency room put me on 5 day predisone an my sugar went from 117 to 266-384 now its 471 I’m worried this way my last day of taking predisone how long before my sugar count will drop ?? Or should I ho back to emergency room for iv treatment?? Help.
I’m a type 2 Diabetic. I just started on the initial dose of prednisone today. My 2 hour post meal BG reading is usually 115-120. Pretty much like clock work. I last ate at 3pm. I drank a lot of water as per usual and have throughout the day. I took a 2 hour nap from 6pm to 8pm. I took my BG reading after the nap and it was 184.
I have Pemphigus vulgaris im given an enjection of Dexamethasone 5 times per month for past 6 months now I have developed steroid indused diabetic and pressure.
&my question is will this comes to normal when I stopped taking the injections.
In December 2016 a ER doctor gave me a low dose of.
Prednisone because he thought I had bell palsy. 36 hours later I was in a different hospital with mini stroke and kidney failure, and I spent 8 days in the hospital getting 6 to 7 bags of saline a day and lots of other meds to save my organs and life. I miss over a month of work recovering. Anybody know a good lawyer in Texas? After confirming my suspicions by reading this article I realize even more that the pompous ER doc that acted like he knew everything (BTW, he knew I was a type two diabetic) almost caused me my life and might kill someonein the future. My blood sugar was 700 and I couldn’t get it down with my lantus or apidra.
Florinef, how does this raise glucose compared to others? I’m t1 and Orthostatic, over many years, now always. Hoping to get diabetes in better control as brittle and will suddenly run high.
Endos here are not much help! Tried hydrocortisone with bs in 400s and was doubling insulin.
Will Florinef raise glucose as significantly?
I am a type 2 diabetic ( age 70 ) . Was on metformin and januvia added later. Past few years added levimeir at night . In hospital last April with asthma , bronchitis ,pneumonia . They added novalog on scale ,came home with that added to my regimen ! Sugar ran very high after adding prednisone in hospital. Back to dr. today and have the same mess as a year . Put me on prednisone again and antibiotic . Sugar went to 388 after 2 hrs . Panacking ! Gave myself 11 u of novalog . And took my metformin ( 1000 mg ) a little early and levimeir . Did taking my 50mg all at once do that . I have 50 to take.
Tomorrow , 40 for 2 days , 3 for 2 days etc.. Is there another way to take it ?
Before all this I was already dealing with a different atidrepressant that was causing a hike in my weight an my bs ! Help !
I am a Type 2 diabetic since 2003. My diabetes has been controlled over the years taking 2 Glimepiride pills ( 4 mg) & 2 Metformin pills (1000 mg) each day. My average daily glucose reading would read between 110 & 127. I started having major surgeries in December of 2016 & the 1st 6 months of this year. For the last 2 months, I have been taking eye drops of Prolensa, Pred Forte, & Zymaxid. My glucose levels began to average 194 in the a.m. before breakfast. Two weeks ago, I started having allergic reactions with my upper & lower forearms breaking out with reddish welts that itch, & redness on my chest. It wouldn’t happen every day, but was getting worse. Started keeping a food & med diary, but nothing seemed obvious. I finished taking the drops 1 week ago. but would still break out. The other night, I decided to eat an ice cream cone with 2 -3 scoops of ice cream. I broke out b4 I could finish the cone. I deduced that the breakout was caused by my glucose spiking so high. Is this being caused by my taking the eye drops Pred Forte? Do you think my glucose level will return to normal & if so, how long? Thanks, Mrs. Haynes.
sir myi mom has colitis ulcers and she is using omminocortil 40mg a steroid but she has no diabetes till now when she started using this medicine her blood sugar level is more its course duration 1month when she stop the using the steroid can it becomes to normal is my mom has no diabetes know sir or she belongs to a diabetic patient plz tell me what can i do for this …
I’m pre diabetic. For the last 3 months I’ve been on a low carb Keto diet eating around 20-30 carbs a day and lost 12lb so now 120lbs . I hoped to lower my BLood Sugar. Just had a blood test this week and I’m still Pre Diabetic. But reading this thread I’m beginning now to wonder if it’s because I take 10 mg Prednisone a day for Polymyagia Rheumatica. Been on these meds for 15 months.
Just made an appointment with my Doctor.
Let us know what you find.
Hope someone can advise me.
I am Type-2 with a well controlled blood sugar (HA1c=6.5 for over 10 years) I just had cataract surgery and my AM fasting blood sugars skyrocketed ( normel 120-130 to 175-200) the first week when I was on Pred Forte 4 times per day. My post-op treatment plan dropped to 2 times per day after a week – the sugars got better but are still 150-175. I am scheduled to stay on this regimen for another 10 days and then go to 1 ti,e per day for 3 more weeks. I wonder whether having this increase in blood sugars for over a month is detrimental to my health. My eye doctor is not too sympathetic to my increase and the endo doc is deferring to the eye doctor.
I am a type 2diabetic I was recently in the hospital for breathing problem I was there for 2 days Dr. gave me shots of methyiprednisolone and on realease gave Rx for 6 day treatment ? Do I have to take the 6 treatment?
I was diagnosed with type 1 diabetes a month ago, and I just turned twelve. Can I please know how much they increase glucose levels, by what number? Does it depend on how you go about it? Any answers?
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