II. Precautions
-
Blood Glucose will typically increase with Systemic Corticosteroids
- Glucose may also increase to a lesser extent with intraarticular or high potency Topical Steroids
III. Management: Short Corticosteroid course
- Most diabetes patients do not require significant changes to regimen when on short courses of Corticosteroids
- Risk of Hypoglycemia as steroid is tapered outweighs benefit of transiently increased regimen
- Indications for closer monitoring and tighter Glucose management on Corticosteroids
- Type I Diabetes Mellitus
- Uncontrolled or poorly controlled Type 2 Diabetes Mellitus
- Approach while on Corticosteroids
- Check Glucose for symptomatic Hyperglycemia (Blurred Vision, Urinary Frequency)
- Contact medical provider for Glucose >400 mg/dl in Type 2 Diabetes, >250 mg/dl in Type 1 Diabetes
- Consider temporary Basal insulin dose increase (10-15%) for significant Hyperglycemia on Corticosteroids
IV. References
- (2018) Presc Lett 25(3)