Drug induced Diabetes

Can medications used for other diseases cause diabetes or can they worsen glucose control in those with diabetes?

This is a commonly asked question by many patients. The answer is simple,some of them do, but many don’t

It is important to know which medications cause blood sugars to go high so that necessary precautions can be taken if you have to take it.  It is also important to realize that most people who develop diabetes are at risk of developing it sooner or later.  Hence if we are able to identify those at risk, we can be more careful when these medications are used.

Which are the common medications that can cause or unmask diabetes?

The most common medications are steroids which are important rugs in treating disorders like asthma,many inflammatory disorders,connective tissue disorders and malignancy.

Anti psychotic agents increase the risk of diabetes by causing weight gain and increasing insulin resistance.  The agents most commonly implicated have been clozapine,olanzapine and risperidone

Immunosuppressive agents like Tacrolimus and Ciclosporin can directly affect the pancreatic function and are usually used in post transplant patients

Other medications include cardiac medications that can slightly increase the sugar readings.  Beta blockers,thiazide diuretics and statins are among them

Does everyone who takes steroids develop diabetes?

Synthetic steroids are widely used for the treatment of many ailments ranging from arthritis to asthma to inflammation.  However, diabetes is certainly one the unpleasant side effects of thse medications,  Many patients develop diabetes when on high dose steroids.  Patients with well controlled diabetes may notice that their diabetes gets worse when on steroids.  Those with high risk for insulin resistance ie obese,those with strong family history of diabetes, are at higher risk for sugars going up.  In most patients once the steroid medications are tapered and stopped,diabetes comes under control,however we do see patients for whom long standing treatment will be required for diabetes.

In asthma steroids are required in large doses only when a sudden worsening of symptoms happens and can be stopped in a few days to a couple of weeks.  Inhaled steroids are almost always very safe and has not significant impact on sugar control.  In some immune systems disorders,steroids are required in large doses for a longer period.  They are very effective medications which can be lifesaving in  many situations

What should you do if you are on these medications?

It is important that you discuss with your doctor regarding the possibility of diabetes if you are on any of thse medications.  Effective steps can be taken to prevent problems related to high sugars if you are close monitoring you diabetes status

Healthy life style is essential while you are on these medications although often regular exercise and strict diet control might be difficult because of background medical problems that the person is suffering from.  Diabetes medications may be required during that period