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Oral Corticosteroids and Diabetes: Understanding the Risks

One of the best defenses doctors have against severe asthma are oral corticosteroids (OCS). This life-saving wonder drug can stop an asthma flare in its tracks by quickly reducing inflammation in the lungs and airways. It’s effective, easy to take, and affordable.

On the other hand, it’s also a very strong medicine that should be used sparingly and wisely. Overuse or long-term use of OCS can lead to harmful side effects – including weight gain and high blood sugar that can trigger or worsen diabetes.

For some, the medication’s effectiveness may outweigh the risks. For others, non-oral forms of corticosteroids, which tend to have fewer side effects, may be preferred. Inhaled corticosteroids are often prescribed first by doctors before turning to OCS.

Steroid-induced diabetes

Oral corticosteroids can increase your blood sugar levels and affect how your body reacts to insulin, the hormone that controls blood sugar levels. In certain patients, this can lead to what’s called steroid-induced diabetes.

Symptoms of steroid-induced diabetes can emerge one to two days after beginning a course of OCS. They include dry mouth and thirst, fatigue, unintentional weight loss, nausea and vomiting, frequent urination, blurred vision, or tingling or loss of feeling in the hands or feet.

If you’re taking OCS and at risk for steroid-induced diabetes, monitor your blood sugar levels regularly during treatment. Talk with your doctor about how to manage diabetes, including insulin treatment.

Blood sugar levels typically return to normal when a course of oral corticosteroids is finished. However, if you continue to experience symptoms after you stop OCS treatment, you should be evaluated for Type 2 diabetes, especially if you have pre-existing risk factors (family history of diabetes, 45 years of age or older, overweight) for the disease.

OCS for asthma

If you need two or more courses of OCS in a 12-month period, this is a sign of poor asthma control and you should speak with your doctor about taking medications with fewer side effects.

Very few asthma patients are required to take OCS long term to control asthma. Those who do are at higher risk for steroid-induced diabetes.

When talking with your doctor, be honest about concerns and fears. Studies have shown that patients experience more side effects from their medicines than doctors realize and may decide for themselves to cut their treatment short.

However, too little medicine might not be enough to do the job. Talk about any unusual symptoms you notice while taking a medication, then work together to find a treatment plan that works.

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