Steroids and Blood Sugar: Diabetes Questions and Answers

By Gary Scheiner, MS, CDCES | September 27, 2022

Q: I have well-managed type 1 diabetes. I’ll be getting a steroid injection and heard that it could really mess with my blood sugar control. What can I expect? And more importantly, what can I do about it?

To get cutting-edge diabetes news, strategies for blood glucose management, nutrition tips, healthy recipes, and more delivered straight to your inbox, sign up for our free newsletters!

A: You heard right. For anyone with diabetes (and even those without diabetes), injections of steroids such as cortisone can cause significant insulin resistance that can last for a week or more. For someone like yourself who has type 1 diabetes, that can produce very high glucose levels. The same thing can happen when taking oral steroids such as prednisone or inhaled corticosteroids.

While it is always important for people with diabetes to manage their glucose levels, it is even more critical to keep blood sugars in check when recovering from an illness or injury. High glucose levels can interfere with the healing process and contribute to longer recovery times and an increased risk of infection.

In most cases, steroid medications take at least a few hours to start affecting glucose levels. Depending on the type and dose of the steroid, the effects tend to peak in one to three days and then taper off. Those who don't usually take insulin for their diabetes may require insulin injections for a short while after receiving a steroid. For those who already take insulin, the dose of basal insulin may need to be adjusted for several days. Additional doses of rapid-acting insulin may also be required to bring any elevated glucose readings down to normal. Talk with your physician or diabetes care team prior to receiving your steroid injection to work up a game plan.

Want to learn more about steroids and diabetes? Read "The Link Between Prednisone and Diabetes" and "Diabetes and Steroids: Can People With Diabetes Take These Medicines?"

Gary Scheiner, MS, CDCES on social media

The Owner and Clinical Director of Integrated Diabetes Services LLC, a private practice specializing in advanced education and glucose regulation for patients utilizing intensive insulin therapy. Scheiner, who has had Type 1 diabetes since 1985, was the AADE 2014 Diabetes Educator of the Year. He is the author of Think Like A Pancreas — A Practical Guide to Managing Diabetes With Insulin, Practical CGM, Diabetes-How To Help (A Guide to Caring for a Loved One With Diabetes), The Ultimate Guide to Accurate Carb Counting, and Until There Is A Cure.

Learn more about Gary Scheiner:

Professional website

Disclaimer of Medical Advice: Statements and opinions expressed on this Web site are those of the authors and not necessarily those of the publishers or advertisers. The information, which comes from qualified medical writers, does not constitute medical advice or recommendation of any kind, and you should not rely on any information contained in such posts or comments to replace consultations with your qualified health care professionals to meet your individual needs.

Tips? News? Healthy recipes?E-Courses for Your Diabetes?Sign Up For Our Newsletters