Steroid-Induced Diabetes: Causes, Risks, Signs or Symptoms, Diagnosis, Treatment | Health

When an individual is prescribed steroids for the treatment of a particular medical condition such as an acute exacerbation of asthma, shortness of breath, severe skin allergies, skin reactions, or other autoimmune conditions, his or her Glucose metabolism is affected where, even in the absence of previous hyperglycemia, it can develop. steroid-induced hyperglycaemia or steroid-induced diabetes. In an interview with HT Lifestyle, Dr. Manoj Chawla, Diabetes Consultant at PD Hinduja Hospital and Khar Medical Research Centre, said, “Steroids are counter-regulatory hormones that oppose the action insulin in the body. Thus, the use of steroids, especially larger doses and longer duration, carries the risk of onset of new steroid-induced diabetes.

What causes IDS to appear in a person?

Dr. Manish Dattatraya Karekar, COO, Pathology at Krsnaa Diagnostics, explained, “Steroid-induced diabetes mellitus (SIDM) is defined as an abnormal increase in blood sugar levels associated with the use of glucocorticoids (steroids) in a patient with or no history. diabetes mellitus. The effect of glucocorticoids (steroids) on glucose metabolism is likely the result of dysfunction in multiple pathways, including glucose sensitivity, the ability to release insulin from pancreatic beta cells, and insulin resistance. insulin in other tissues.

He explained: “The combined effect being elevated blood glucose levels above recommended levels, resulting in steroid-induced diabetes mellitus. There has been an increase in SID cases after Covid, due to the use of glucocorticoids in the treatment of COVID cases.

Who is at risk of suffering from IDS?

According to Dr. Manish Dattatraya Karekar, the duration of steroid intake, the relative potency (drug strength) of the glucocorticoid, and the absolute dose all play a role in the onset of SIDM. He revealed, “Glucocorticoids are widely used in almost every subspecialty of medicine. Indications for short-term acute corticosteroid therapy can be seen in worsening chronic obstructive pulmonary disease, acute gout, chemotherapy protocols, bacterial meningitis, and in pregnant women for fetal lung maturation, to name a few. to name just a few.

He pointed out that disease processes benefiting from chronic glucocorticoid (steroid) use include lung diseases such as autoimmune diseases; neurological diseases such as myasthenia gravis and multiple sclerosis; and inflammatory bowel (gut) disease. He said: “More recently, chronic corticosteroid therapy has played an important role in modulating the immune system after solid organ transplantation. Proposed risk factors for steroid-induced diabetes beyond cumulative dose and longer duration of steroid treatment include traditional risk factors for type 2 diabetes: advanced age, family history, index of high body mass and impaired glucose tolerance. All the groups mentioned above are at risk of suffering from SIDM »

What are the main signs and symptoms observed in a person suffering from IDS?

Dr. Manish Dattatraya Karekar revealed, “Some key symptoms include frequent urination, feeling thirsty, dry mouth, blurred vision, fatigue, and other symptoms common to DM.”

What diagnostic tests are prescribed to detect IDS?

Dr. Manish Dattatraya Karekar said: “Diagnosis of steroid-induced diabetes, like other types of diabetes, is done by measuring blood sugar. By understanding the patient’s history of taking steroids – as part of a treatment plan and undergoing tests including – fasting blood glucose test, oral glucose tolerance test, HbA1C test and A random blood glucose test can identify and diagnose SIDM.

What are the treatment measures followed to treat SIDM? Can SIDM be treated permanently?

Dr. Manoj Chawla claimed that treatment is similar to other forms of diabetes management and includes lifestyle modification, use of oral medications and occasionally use of insulin to overcome severe hyperglycemia caused by the impact of steroids. He said: “In such cases the need for continued steroid use is assessed and very often once stopped the hyperglycaemia reverses. Sometimes, when steroids have only unmasked hidden type 2 diabetes, it may persist even after steroid use is stopped.

He concluded: ‘Thus SIDM can be completely reversible where the patient’s previous blood sugar was absolutely normal and the use of steroids is temporary, as we have seen during the Covid pandemic where there was use blind from steroids for fear of lung disease and hypoxia. Once detected with the SIDM, the Hba1c test would help differentiate between pre-existing hidden diabetes and new steroid-induced hyperglycemia.