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Diabetes

Prednisone induced diabetes

01/22/2007

Question:

Regarding prednisone induced diabetes, the information I have seen suggests that diabetes can be induced as a result of taking prednisone but that diabetes so induced is transient in nature, except where physicians respond by treating with insulin.

In those cases, what would have otherwise been a temporary condition evolves into a chronic condition requiring life-time insulin therapy. Is this true? Would a person who developed diabetes as a result of taking prednisone been predisposed to developing diabetes anyway? Would the diabetes have resolved if insulin therapy had not been started?

Answer:

Prednisone is a drug which is similar to the hormone cortisone or cortisol produced by the adrenal gland.  These are all members of the molecules referred to as glucocorticoids, which are frequently used for treatment because they reduce inflammation but were named based on their action on glucose or sugar.  All act in the direction of raising blood sugar. 

They are likely to cause abnormalities in blood sugar primarily in people predisposed to diabetes when used at lower doses.  The higher the dose used, the more likely blood sugar will become abnormal and that effect may then be seen in people with less of a predisposition to diabetes. 

The use of insulin does not alter the likelihood that diabetes may manifest when these drugs are used will be permanent.  It may be the other way round:  insulin is likely to be used in those with the most severe abnormalities in blood sugar resulting from the prednisone and those are the ones who are likely to need ongoing treatment for diabetes. 

Please recognize however that the insulin DID NOT CAUSE that situation - its use is a result of that situation.

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Response by:

Robert M Cohen, MD Robert M Cohen, MD
Professor of Clinical Medicine
College of Medicine
University of Cincinnati