Steroid induced diabetes

Hi all,

I’m sorry if this is a bother, I know my diabetes story isn’t really what other people have experienced (T1 or T2). A year ago I was diagnosed with MS (well, technically a sister disease of MS, NMO, but no one knows what I’m talking about when I say NMO) and have been on and off of steroids like methylprednisolone and prednisone since.

I’m currently very pregnant (three weeks to go!) and my neuro is putting me back on steroids because of a current issue. My last go with steroids left me with high blood sugars and a diagnosis of diabetes from my GP a few months after I had stopped my steroids, but then when re-checked during pregnancy, apparently my blood sugars were back to normal with an A1C of 5.4, if I recall correctly.

Anyhow, I know going into this next steroid regimen, I may very well get steroid-induced diabetes again. This is concerning because of my pregnancy, but I’m very aware of it. I know I should go easy on carbohydrates and monitor my blood sugar, but I don’t have any real correcting measures available to me. Does anyone have any experience with steroid-induced diabetes or any tips to keep this under control til I give birth?

Congratulations! New babies are the best. Best wishes. And, no bother. This is what we do here.

I approach steroids very carefully and refuse them, usually, when prescribed. With D, is there something else they can prescribe for you?

My father had some problems that put him on steroids. Tried to talk him out of taking them (he really never needed them and he told all the docs that, but they said "take them," so he did.) A few months later he told me he had T2. His doc sent him to a bunch of diabetes classes, put him on meds. I was concerned, but once his doc wanted him to take insulin, I blew a gasket. Called the doc and told him to take him off the steroids NOW. Well, long term steroid treatment cannot be stopped immediately..... even if it was causing the T2. He was 86.

I had some problems a few years ago that steroids were used. One dose and my BG levels SHOT through the roof within an hour--higher than I had ever experienced.

I knew Dad's T2 was steroid induced. We weaned him off of them and the higher BG numbers disappeared.

Just be aware of the impact. You don't say if you are T1 or T2. Let us know, and we may have some tips if you with the steroid treatment, but it is very different with and without insulin.

Good thoughts to you and good luck, Megan.

I suppose I’d be closer to Type 2 than anything, but neither my OB or GP consider me to have either right now since my last A1C and OGTT were within normal ranges without any sort of treatment - it’s just the steroids that make me go way hyper, and then after I finish the steroids it seems like I correct myself, or it could be the pregnancy making me correct myself, I have no idea. Both NMO and pregnancy are new to me, so it’s hard to tell what’s up and down right now.

What I know for sure is that my fasting and postprandial BG is well out of normal range when I go on steroids and will certainly go out of normal range for pregnancy.

Congratulations Meagan!! :)

I'm Type 1 not Type 2 but I just wanted to mention that 2 of my Friends had Gestational Diabetes when they were pregnant. They were both put on Insulin because in the last tri-mester the blood sugar of Diabetics usually rises higher. They were also given a meter and strips to test, so they could correct when needed. They both had the Diabetes after the 4th month of pregnancy.

It must be something important that they want you on steroids now.
They would probably put you on low dose? I think that it is only the first trimester that it may cause a problem for the Baby. You really should ask them about that. I can understand your concern considering the Diabetes and the Baby.

When I was pregnant(way back when) they used to take Diabetic women's babies out 1 month early since the blood sugars would get out of control at that point. Keeping in mind, I'm a Type 1. Now they usually put them on pumps if they aren't on one already, so they can go full term. My Friends(Type 2's) were just put on Insulin until the end of their pregnancies and then were taken off the Insulin after they checked out okay. I'm glad that you don't have long to go. I hope that you and Baby are okay and Good Luck. :)

If you haven't been there already, there is an "Oh Baby" group here for Diabetics who are pregnant. They could answer your questions.

Steroids are known to cause high BGs. Before you start please check in with your OB, as well as with endo and get set up with insulin to correct the highs that will come. You do not want to put the baby at risk.
Once you are able to get of the roids then you will be able to be off insulin. Oral meds will not usually give you the control you will need for both you and the baby.

Thank you for your responses, everyone. I started my prednisone yesterday and I have seen some elevated numbers, but nothing too concerning yet (140 2 hours pp last night, 115 fasting this morning). I'll see my OB tomorrow and talk more to her about what I should do if I see higher numbers and what numbers she sees as concerning.

I'm two weeks away from my c-section date now (baby has a cord defect and with my autoimmune stuff, it's just safer) and my prednisone regimen will end right before that date.

HI! I have no input on your problem. BUT I do want to comment on your comment about being a bother. You are NOT a bother. If it concerns you, then [this being a really large community], it concerns us. Petty or major (and who defines that?), it is on your mind and worthy of attention from the other members of this community.

Take care and I hope you have an uneventful delivery and recovery from all your problems.