Food To Avoid While On Prednisone: Sugar
First of all, we focus on sugar and avoiding it. Sugar is basically poison to people taking prednisone especially simple sugar like white sugar, white rice, white flour, those refined carbohydrates that your great-great-grandmother has never heard of. She has never seen things like candy in wrappers. We need to focus on foods that she would recognize. We need to stay out of the middle of the grocery store and focus on traditional foods that people have eaten for millennia. Only the real foods, whole foods: that is how we can avoid having too much sugar. So what exactly aside from flour and sugar am I talking about?
I am talking about things that come out of the bakery like bread, rolls, boggles, donuts, or all those good delicious things. Especially, when theyre made of white flour. Theyre really bad for us especially when we are on prednisone. They turn right into sugar and straight into fat and all of those horrible consequences of high blood sugar.
- Food Examples
- Bakery: Cookies, Cakes, Bread, Donuts, Rolls
- Frozen Meals
Prednisone Diabetes And Safety
Prednisone and diabetes do not have to be a dangerous combination as long as people who use prednisone understand the risks especially if they already have type 2 diabetes. Blood sugar management and healthy lifestyle behaviors are key to staying safe while using prednisone and living with diabetes.
If you are living with diabetes or caring for someone diagnosed with diabetes, browse our database of healthy recipes, tips on nutrition and exercise, and our many other diabetes resources. Our mission is to provide you with the information you need to safely and effectively manage diabetes.
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How To Counteract Prednisone Side Effects
Compromised immune system
Turns out, prednisones greatest asset is also itsgreatest weakness. The very action that makes prednisone so effective itsability to mute the immune system and relieve symptoms can also lead to an increasedrisk of illness and infection, since your bodys defenses are low.
What you can do: Practice healthylifestyle habits, including getting enough sleep and eating healthfully. Treatyourself well, Dr. Ford says. Anything you can do to stay healthy is going tobenefit you and reduce some of the problems associated with prednisone.
Fluid retention is one of prednisones most famousside effects. Moon face is common, which is swelling in the face that canoccur after youve been on steroids for a long time, Dr. Ford notes. You can alsoget swelling in the legs and midsection.
What you can do: Prednisone alters how the body processes salt, so staying on alow-salt diet can help to some degree, he says. And exercise can help keepexcess weight off.
While prednisone is not a stimulant, it can make youfeel more alert or jittery. It doesnt really interrupt sleep, but somepatients find it keeps them awake when they dont want to be, Dr. Ford says.
What you can do: If its possible, werecommend you take your whole dose in the morning, he recommends. Then hopefully,that sense of extra alertness will dissipate by bedtime.
Prednisone may cause gastrointestinal symptoms when youtake it on an empty stomach.
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Mental Health Side Effects
Early on in treatment , prednisone may increase feelings of well-being, anxiety, hypomania or mild euphoria. With long-term therapy, however, patients may develop depression. Psychosis, referred to as corticosteroid-induced psychosis, can occur at doses of 20 mg or more per day with long-term use.
About 1.3 percent of psychosis cases occurred in patients taking 40 mg or lower, while 18.4 percent occurred in patients taking 80 mg daily. Patients with a history of mental health issues and female gender are at greater risk.
Mental health symptoms start within three to four days after starting therapy, but they can occur at any time. Some people have symptoms, including depression, after stopping therapy.
In children receiving prednisone for acute lymphoblastic leukemia , prednisone may cause behavioral symptoms including aggression, insomnia, mood fluctuations, depression, manic behavior and euphoria. Most children no longer experience these symptoms after they stop therapy.
The Peoples Pharmacy Perspective:
Dozens of other drugs, including statins and diuretics, can also interfere with blood glucose control. You can learn more about these in our eGuide to Preventing & Treating Diabetes.
We also discuss nondrug approaches such as cinnamon, vinegar, curcumin and coffee or supplements like selenium, bitter melon, fenugreek or nopal cactus. You will find it in the Health eGuides section.
Physicians should alert patients to the possibility that a medication could raise blood glucose when they prescribe it. There is a clear connection between prednisone and diabetes.
No should ever discontinue prednisone suddenly! If it becomes necessary to stop this corticosteroid, it should only be done under medical supervision. A gradual tapering is essential to prevent other serious complications.
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Does Insulin Lower Iop
The relationship between diabetes and glaucoma is incompletely characterized. In some but not all studies, diabetes has been shown to be a risk factor for glaucoma, but in the Ocular Hypertension Treatment Study, diabetes was found to be a protective factor that reduced the risk of developing glaucoma among subjects with elevated IOP.
A research team led by Muhammad Abdulrazik, M.D., Al-Quds University, Jerusalem, investigated the intriguing hypothesis that initiating insulin therapy in diabetic patients results in a clinically significant reduction in IOP.
Although previous studies have shown that insulin therapy appears to have no effect on IOP, unexpected IOP findings from follow-up of patients initiating insulin therapy have justified a reassessment, Dr. Abdulrazik said.
They evaluated a series of 21 subjects with type 2 diabetes scheduled to begin therapy with subcutaneous insulin. IOP was measured on several occasions over a three-week period before the initiation of therapy and again several times after three months of insulin therapy.
Statistically significant changes in IOP from baseline were observed in patients after the third month of insulin therapy, said Dr. Abdulrazik. Interestingly, the IOP-lowering effect of insulin was inversely related to body mass index .
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Prednisone And Diabetes: A Life
We have described prednisone as a Deal with the Devil. Thats because this drug is the classic double-edged sword. It can save lives and make life worth living for some people. For others, though, it can cause serious side effects including edema, insomnia, irritability, hypertension, glaucoma, cataracts, ulcers, blood clots, weakened bones and osteoporosis. There is also an association between prednisone and diabetes which in some cases can be life threatening. Here is one such report.
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Basal Endogenous Glucose Production And Two
An intravenous cannula was inserted into the antecubital fossa of one arm for administration of infusions. A distally sited cannula was inserted into the contralateral arm for blood sampling and was heated for the duration of the study to achieve arterialization of venous blood. After baseline blood samples were drawn, subjects were administered a primed continuous infusion of 6,6-2H2 glucose for 120 min to estimate basal EGP. Steady state was defined as 90 to 120 min after completion of the priming bolus.
A two-step hyperinsulinemic-euglycemic clamp study followed immediately. In the first step, the low-dose clamp study, human neutral insulin was infused for 120 min at 15 mU/m2/min. The basal 6,6-2H2 glucose infusion was continued at 50% of the initial rate during this step. In the second step, the high-dose clamp study, the basal 6,6-2H2 glucose infusion was ceased and subjects were administered a primed human neutral insulin infusion at 80 mU/m2/min for 120 min. During both the low-dose and high-dose clamp studies, subjects were administered a variable infusion of 25% glucose enriched to 2.6% with 6,6-2H2 glucose to maintain euglycemia with a target glucose concentration of 5 mmol/L. Blood samples were drawn every 5 to 10 min to titrate the variable glucose infusion and steady state was defined as the last 30 min of each step of the clamp study.
Dealing With Elevated Blood Glucose
For nondiabetics, acute hyperglycemia results from prednisone are usually mild, and blood glucose levels gradually return to normal once the drug is tapered off. If you chronically use prednisone at high dosages, you may develop steroid-induced diabetes, and your doctor will provide appropriate treatment. This may mean starting diabetes medications such as insulin. If you are diabetic previous to prednisone therapy, you doctor may increase your dosage of insulin. These decisions are dependent on your overall glucose control or A1C and blood glucose patterns. Check your blood glucose more frequently, about 4 to 6 times a day for several days, and discuss your glucose log with a certified diabetes educator or endocrinologist. Do the same while tapering off prednisone, since your blood glucose levels are likely to drop. Reducing diabetes medications may be necessary to prevent hypoglycemia.
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Which Blood Tests & Lab Values Does Prednisone Change
If youve already been following me for a while you may have seen the nutrients which are depleted by prednisone as shown below. It shows that prednisone depletes calcium, chromium, and other vitamins. Were going to focus on a few of those and show how prednisone changed my personal lab values.
How Are Steroids Used
There are many different ways one can take steroids. The most common is by mouth in the form of tablets, capsules, or syrups. Steroids can also be ingested via an inhaler or intranasal spray, most commonly to help alleviate asthma attacks or inflammation from seasonal allergies.
Steroids can also be applied topically in the form of creams and ointments to help heal skin conditions.
Finally, steroids administered by injection are the most common way to treat pain and inflammation people may experience when they suffer from tendonitis.
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Side Effects In Women Vs Men
Overall, women are at greater risk of side effects from prednisone than men. They are more likely to resist increases in dosages because of side effects. Women also reported more intolerable side effects than men.
Side effects reported more often in women than men include:
- Weight gain
Michelle Llamas has been writing articles and producing podcasts about drugs, medical devices and the FDA for nearly a decade. She focuses on various medical conditions, health policy, COVID-19, LGBTQ health, mental health and womens health issues. Michelle collaborates with experts, including board-certified doctors, patients and advocates, to provide trusted health information to the public. Some of her qualifications include:
- Member of American Medical Writers Association and former Engage Committee and Membership Committee member
- Centers for Disease Control and Prevention Health Literacy certificates
- Original works published or cited in The Lancet, British Journal of Clinical Pharmacology and the Journal for Palliative Medicine
Treating Diabetes When On Steroids
If you have diabetes prior to starting on oral corticosteroids, you need to be aware that your blood glucose levels may rise whilst you are taking steroids. This is more likely to be the case if you are taking steroids orally.
If you do not currently monitor your blood glucose levels at home , you may wish to ask your doctor if a prescription for home blood glucose testing will be appropriate.
If your blood glucose levels rise significantly, you may need to increase or change your diabetes medication.
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Niacin To Bring Down Bad Cholesterol
Niacin is a B vitamin available as an over-the-counter supplement. It can have cholesterol-lowering effects, but like statins, it can also raise blood glucose in people with diabetes. A study published in February 2016 in the journal Heart also concluded that niacin increases the risk of developing diabetes in the first place.
Glucocorticoids Can Cause Significantly High Blood Sugar These Hormones Decrease Insulin Effectiveness And Cause Liver Glucose Dumping
Certified diabetes educator Becky Wells recently retired from working with a diabetes self-management education program at Hendrick Medical Center in Abilene, Texas. She has shared her Ask the Diabetes Educator advice columns from that program with Insulin Nation.
Question: Sometimes my doctor prescribes steroids or gives me a steroid injection when Im sick. This always makes my blood sugar levels go up, and nothing I do seems to get them down. What should I do?
Answer: The use of steroids can cause significantly high blood sugar levels. These hormones decrease the effectiveness of insulin and make your liver dump more glucose into your bloodstream. Some people can have blood sugars as high as 400 mg/dL to 500 mg/dL while taking steroids. These kinds of levels can lead to the need for hospitalization, IV fluids, and/or extra insulin in people with Type 1 or Type 2 diabetes.
Remind your doctor about your diabetes when he prescribes steroids and ask if its necessary for you to take them. If steroids are necessary, ask how often you should check your blood sugar and whether your diabetes medications should be adjusted. If the steroids are prescribed for a short time , your doctor may decide not to change your medication. If steroids are used over a longer period of time, its important to note that the dosage levels are slowly tapered off. Insulin amounts will need to be decreased as steroid levels decrease.
How Long Will Prednisone Affect Blood Work
You could expect a dose or prednisone to be out of your system in 16.5 to 22 hours. The elimination half life of prednisone is around 3 to 4 hours. This is the time it takes for your body to reduce the plasma levels by half. It usually takes around 5.5 half lives for a drug to be completely eliminated from your system.
What You Need To Know When Starting Steroid Therapy
Remind your doctor that you have diabetes. Your doctor may adjust your dose of steroid medication to minimise the risk of side effects.
- Make sure you understand how to take oral steroid medication safely.
- As steroid medications can cause blood glucose levels to increase, talk to your doctor or credentialled diabetes educator about monitoring your levels more closely. Ask them for advice on managing your diabetes if your blood glucose levels are above the target range.
- Ask your doctor or credentialled diabetes educator whether your dose of diabetes medication or insulin needs to be adjusted while you are on steroid medication.
- Continue to follow a healthy eating plan and do regular physical activity.
- If you are on long-term steroid treatment, wear some identification such as a Medic Alert bracelet.
- If you have been taking oral steroid medication for a long time, its important NOT to stop suddenly. Your doctor will provide you with instructions on how to stop your medication gradually.
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Effects Of Steroid Hyperglycemia
Despite its frequency, little is known about the impact of hyperglycemia associated with steroid use on clinical comorbidities and mortality. It is known that rheumatic diseases per se represent an important cardiovascular risk factor, which makes them the leading cause of premature mortality in these patients. Therefore, it is thought that the coexistence of inflammatory diseases and steroid-induced hyperglycemia may lead to worse cardiovascular consequences. Similarly the diabetic patient possesses a traditional cardiovascular risk factor for microvascular and macrovascular complications.
Fluctuations in serum glucose levels have been associated with increased cardiovascular mortality associated with increased LDL cholesterol, endothelial dysfunction, activation of the coagulation cascade, increased pro-inflammatory cytokine production, and oxidative stress resulting in macrovascular disease progression. Several studies have reported that transient increases in serum glucose are associated with acute inflammatory processes and endothelial dysfunction in both diabetic and non-diabetic patients.
How To Treat Prednisone
People who are using prednisone to treat certain medical conditions should talk to their doctors about alternative treatments that will not spike blood sugar or increase the risk for type 2 diabetes. In some cases, doctors may prescribe different medications or recommend healthy lifestyle changes that could improve their conditions.
Those who must continue using prednisone should monitor their blood sugar levels regularly and work with their doctors to prevent or control diabetes. People who are already diagnosed with type 2 diabetes should check their blood sugar levels at least four times per day and use higher doses of insulin as advised by their doctors. These individuals should also keep glucose tablets, juice or candies with them at all times to treat hypoglycemia in the event that blood sugar levels should drop abruptly.
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Irl Diabetes And Steroids Stories
The obvious caveat to all of this is that , individual diabetes experiences may vary.
When DiabetesMine reached out to the diabetes online community on this topic, dozens replied saying theyd experienced huge jumps in blood sugar after using various types of steroids.
Laura Higgins of Utah, whos lived with T1D for almost two decades since age 13, says shes seen big BG spikes after being on steroids several times through the years. But she knew the risks and worked with her diabetes education and care specialist to best manage those fluctuations.
Her partner had a different story, however. He was diagnosed with type 2 diabetes a couple of years before they started dating, and earlier this year an urgent care doctor prescribed steroids for bronchitis, without even inquiring or looking at his chart, and not explaining the blood-sugar risks and potential for diabetes ketoacidosis .
By this time I had coached him into how to manage his diabetes and he was testing with all these crazy numbers over 400 mg/dL, she says. She noted that with her backup Novolog insulin pen she had taught him to use, her husband was dosing 30+ units to bring his numbers down to more manageable levels.
He finished the steroids and I got him in with the primary care doctor that my manages my type 1 because I was so appalled at the negligence, she tells DiabetesMine.
Others echoing similar experiences preferred to have their names withheld: