Blood Sugar Issues with Steroids

It is no secret that steroids can wreak havoc on our bodies. I have been on and off of them for years. Sometimes my tapers drag on for months because my asthma can be so difficult to control. The longer steroids are used the greater the potential for more significant side effects. And boy did I win the jackpot there, let me tell you! I have experienced everything from an insatiable hunger to steroid-induced psychosis, and everything in between.

It is not uncommon for steroids to have a profound effect on blood sugar. People who have diabetes have a particular struggle when they need steroids, but even people who have no history of diabetes can have markedly elevated blood glucose levels when they need a course of steroids.¹

Treating my asthma with steroids caused a change in blood sugar levels

My pulmonologist started to get concerned about my sugar levels a few years ago. The plan was to avoid them as much as possible, but with my asthma being so severe, it was inevitable that I would get another round sooner rather than later. My blood sugar issues started out like most people who take steroids. I would get very high sugar levels when starting, but then they would eventually level off.

But after a few years of this, something different started happening. After the first few days of high sugars, my blood glucose started to drop. First into the 70s (which is still considered normal). Then into the 60s. And a few rounds of steroids later, my blood sugar would start dropping into the 50s a few days after a new round of steroids started.

Well, that’s weird. If blood sugar typically elevates while on steroids, why was mine dropping so drastically low? My primary care physician (PCP) referred me to an endocrinologist. He was very confident after my first appointment with him that I had adrenal insufficiency. But, one ACTH stimulation test later, it was determined not to be adrenal insufficiency.

I am a unicorn

It is not uncommon for the body to react in unexpected ways as it relates to chronic illness, but there are usually good explanations or case studies of other patients who have similar reactions, but this one has my doctors stumped. Oh goody, another reason my body should be donated to science when I die.

How to treat a unicorn

But what do we do about it? We have already established that avoiding steroids is unachievable, that is how I found myself in this predicament in the first place. The first medication I tried, just made my sugar drop even more, so that was a no-go. I started working with a dietician who specialized in diabetes. We worked together for months trying to figure out how I could modify my diet to prevent my blood sugar from crashing. That worked for a while. And then it didn’t.

I was transferred to another endocrinologist, as the one I was seeing left the practice. She was certainly stumped too but took an unconventional approach to managing my sugar. She decided to try me on a medication that is typically used to prevent type 2 diabetics from having elevated blood sugar. But the way this medication works, it actually regulates blood sugar levels, not just keeping them from getting too high. The theory was that this regulation would keep my blood sugars from getting too high at the beginning of a round of steroids and then getting too low after a couple of days.

And wouldn’t you know? It worked! My primary care doctor was flummoxed when I told her the type of medication the endocrinologist put me on. She commented, "I NEVER would have thought to put you on that!"

Although I have had to increase the dose of this medication a couple of times, it continues to work well for me. While I still get low blood sugar sometimes, it is much fewer and farther between than it used to be. I do still have to watch what I eat and make some lifestyle changes, but I am able to function pretty normally and not constantly be thinking about my blood sugar levels like I was before.

Have you had blood sugar issues related to the use of steroids for asthma treatment? Let us know about your experience in the comments, or by clicking the button below to share your story with the community.