diabetesDE recommends blood sugar tests before and during cortisone therapy

01.02.2011 11:45

Corticosteroids can cause type 3e diabetes and hyperglycemia.

Cortisone and other corticosteroids can increase blood sugar levels and promote insulin resistance. This can trigger type 3e diabetes or, if you already have diabetes, lead to an increase in blood sugar. According to a Canadian study, high-dose cortisone sprays against respiratory diseases in particular promote the development and worsening of diabetes. diabetesDE therefore recommends blood sugar tests before and during therapy with corticosteroids. In the case of insulin-dependent diabetics, treating physicians must adjust the insulin dose accordingly during therapy and monitor it regularly.

Anti-inflammatory corticosteroids may contribute to both the onset and worsening of diabetes mellitus. They cause blood sugar levels to rise and reduce sensitivity to the blood sugar-lowering hormone insulin. “The external local application of cortisone, for example as an ointment on the skin, does not play any role in sugar balance,” explains Professor Dr. med. Stephan Matthaei, Vice President of the German Diabetes Society (DDG) and chief physician of the Diabetes Center at the Quakenbrück Christian Hospital. “In addition to the long-known effect of a deterioration in blood sugar metabolism control caused by tablets or injections containing cortisone, a study has now shown that inhalation sprays containing cortisone can also increase the risk of developing diabetes and can lead to a deterioration in blood sugar metabolism in those who already have diabetes,” emphasizes the diabetologist. Treating doctors should therefore measure the patient's blood sugar level before initiating cortisone therapy in order to detect elevated values or even a previously unknown manifest diabetes disease from the outset. If diabetes occurs as a result of cortisone therapy, it is called diabetes type 3e.

People with asthma or chronic obstructive pulmonary disease (COPD) are often prescribed inhaled corticosteroids. According to a Canadian study published in December 2010 in The American Journal of Medicine, inhalation sprays containing cortisone, especially when used in high doses, can increase blood sugar levels. Researchers from Montreal came to this conclusion after evaluating data from more than 380,000 patients with respiratory diseases. They examined the health development of the study participants over a period of five and a half years. During this time, over 30,000 patients developed diabetes mellitus while receiving inhaled corticosteroid therapy. More than 2,000 study participants with pre-existing diabetes had to switch from tablets to insulin injections. Regular inhalation of corticosteroids increased the relative risk of developing type 3e diabetes by 34 percent, and in high doses by 64 percent. In patients with type 2 diabetes who took blood sugar-lowering tablets, the risk of having to switch to insulin therapy because of corticosteroids also increased by more than 30 percent. If they inhaled high-dose corticosteroid sprays, it increased by more than 50 percent.

“During treatment with corticosteroids, treating physicians should therefore regularly check their patients’ blood sugar levels,” says Professor Matthaei. For patients with diabetes who are already injecting insulin, the dose may need to be adjusted accordingly.

The name type 3 diabetes includes diabetes diseases with different causes. This includes diabetes as a result of diseases such as cystic fibrosis, inflammation of the pancreas or infections. Tumors, operations, genetic defects or medications such as cortisone can also trigger type 3 diabetes.

Further information can also be found at www.diabetesde.org:

http://www.diabetesde.org/ueber_diabetes/was_ist_diabetes/habe_ich_diabetes/wissenswertes_ueber_diabetes/

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