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Diabetes

Long term prednisone usage

08/24/2009

Question:

Hi. I started using prednisone in 2006 for about 1 year with a dosage of roughly 16mg/day on a daily (sometimes every other day) basis to treat severe Acne. At the time, i did not know the serious side effects of the drug. By start of 2007, I switched to Roaccutane and began reducing the dosage and frequency of prednisone. Before the transition I had a blood test and it seems my bodily functions were normal (including blood sugar). And around late 2007 (October) I pretty much stopped taking either medicines. However, I did not have a follow up examination such as a blood test since the last one in 2007. After roughly 2 years now, I only just recently discovered the scary side of the drug (especially steroid induced diabetes), and it got me worried. Therefore, I am just wondering (obviously I know the best way is to have a blood test or examination done) if I would be subjected to any of the commonly known side effects of the drug on a permanent basis. Thank you.

Answer:

It is impossible to be certain whether people who develop diabetes during or after steroid use would have developed it anyway.  However, my general impression is that the vast proportion who do develop it, especially after going off the drug,were at substantial risk and likely would have gone on to diabetes.  The metabolic effects of prednisone should persist basically only as long as the drug is being used.  Consequences of structural changes, like fat accumulation, bone density loss and cataracts, could be more persistent.

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Response by:

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