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Tuesday, September 30, 2014
Drug induced diabetes
How do you know when prednisone induced diabetes is over? Do you taper insulin while monitoring glucose if glucose levels are going down?
Please review some of the other questions we have answered in the past about steroids and diabetes. It can be very tricky to answer the question you are raising. In practice, it can be common to taper any therapy and evaluate what the blood sugar control is like at each stage and see whether continued tapering is appropriate. However, it is important to keep in mind that steroid-induced diabetes probably occurs primarily if not exclusively in people with some predisposition towards diabetes. Therefore, blood sugar control may improve as steroids are removed but it is important to continue monitoring at some interval afterwards because there is an increased likelihood that the diabetes will return whether or not steroids are administered in the future. My own bias is that increased likelihood is due to the underlying predisposition to diabetes rather than necessarily being caused by the exposure to steroids.
Robert M Cohen, MD
Professor of Clinical Medicine
College of Medicine
University of Cincinnati