II. Precautions

  1. Blood Glucose will typically increase with Systemic Corticosteroids
    1. Glucose may also increase to a lesser extent with intraarticular or high potency Topical Steroids

III. Management: Short Corticosteroid course

  1. Most diabetes patients do not require significant changes to regimen when on short courses of Corticosteroids
    1. Risk of Hypoglycemia as steroid is tapered outweighs benefit of transiently increased regimen
  2. Indications for closer monitoring and tighter Glucose management on Corticosteroids
    1. Type I Diabetes Mellitus
    2. Uncontrolled or poorly controlled Type 2 Diabetes Mellitus
  3. Approach while on Corticosteroids
    1. Check Glucose for symptomatic Hyperglycemia (Blurred Vision, Urinary Frequency)
    2. Contact medical provider for Glucose >400 mg/dl in Type 2 Diabetes, >250 mg/dl in Type 1 Diabetes
    3. Consider temporary basal Insulin dose increase (10-15%) for significant Hyperglycemia on Corticosteroids

IV. References

  1. (2018) Presc Lett 25(3)

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