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DIABETES AND STEROID MEDICATIONS PATIENT INFORMATION LEAFLET

DIABETES AND STEROID MEDICATIONS PATIENT INFORMATION LEAFLET Sometimes people with diabetes may need to take steroid medications to help manage other conditions such as asthma arthritis autoimmune diseases and dermatitis or as part of chemotherapy Reasons for Using Steroid Medications Steroid medications are used for many reasons including 1 To reduce pain and inflammation 2 To prevent nausea during medical procedures 3 To prevent nausea for patients on chemotherapy Your body naturally produces steroid hormones also called corticosteroids to help it fight stress injury and disease Steroid medication has a similar e ect on the body as the steroid hormones produced naturally There are many di erent types of steroid medications which include 1 Cortisone 2 Hydrocortisone 3 Prednisolone 4 Dexamethasone Steroid medications can be taken in various ways including 1 Orally as tablets or liquid 2 With an inhaler 3 By injection into a joint vein or muscle 4 Drops for eyes or ears 5 Cream applied to the skin How Do Steroid Medications Affect My Blood Glucose Levels Steroid treatment increases the amount of glucose produced by the liver Steroids can also reduce the action of insulin causing insulin resistance Insulin is the hormone that controls glucose levels in the blood If your body is unable to produce enough insulin to control the increased production of glucose by the liver your blood glucose levels will rise above normal

If you were testing your blood glucose levels prior to taking steroids you may notice that your blood glucose levels are raised or more di cult to control This is called Steroid Induced Hyperglycaemia The timeframe in which these medications begin to a ect your blood glucose levels can vary depending on how you are taking them Oral steroids Blood glucose levels may begin to rise within a few days of starting oral steroids Their e ect on blood glucose levels will depend on the time dose and type of steroid you are taking Steroid injections Blood glucose levels may rise soon after the injection and may remain high for 3 10 days afterwards Creams used for skin conditions and inhaled steroids used for asthma and ear and eye drops are unlikely to a ect blood glucose levels What You Need To Know When Starting Steroid Therapy 1 Remind your doctor or nurse that you have diabetes Your doctor may adjust your dose of steroid medication to minimise the risk of side e ects 2 Make sure you understand how to take oral steroid medication safely 3 If you were testing your blood glucose levels before starting steroids please see next section If you were not testing your blood glucose levels before starting steroids discuss with your doctor or nurse if it will be necessary for you to check blood glucose levels at home

Treating A Low Blood Glucose 1 If you are able to test your blood glucose a reading under 4mmol l will confirm a hypo 2 If you recognise you are having a hypo TREAT immediately with Lift Glucojuice or 170ml Lucozade or 4 large jelly babies or 150mls orange juice If you do not feel better after 5 10 mins repeat When you feel better and your blood sugar is 4mmol l or higher have a small starch snack a banana or brown bread sandwich or a glass of milk Please contact your diabetes nurse or GP for advice if you have a low blood glucose to review your diabetes medication What To Do When Steroids Are Stopped 1 Continue to monitor your blood glucose levels once a day or more often if that is your normal regimen until the sugars return to normal between 4 7mmol l 2 If your readings are higher 12mmol l or above more than twice in 24 hours contact the your Diabetes Nurse Specialist or GP for advice 3 You may wish to delay having a HBAIC test performed for 3 months to exclude the e ect of the steroid treatment 4 Some people have intermittent steroid therapy and require insulin treatment each time they have steroid treatment In this instance keep all unopened insulin pens in the fridge and check the expiry date

5 Insulin pens can be used for 28 days after opening and should be discarded after this time even if some product remains This information leaflet is intended as a guide only It should not replace individual medical advice and if you have any concerns about your health or further questions you should contact your health care professional References https www ndss com au about diabetes resources find a res ource steroid medications and diabetes fact sheet Training Research and Education for Nurses in Diabetes UK TREND UK 2015

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