Glucocorticoid Hyperglycemia: How Steroids Raise Blood Sugar and What to Do

When you take glucocorticoid hyperglycemia, a condition where steroid medications cause elevated blood sugar levels. Also known as steroid-induced diabetes, it’s not a new disease—it’s your body’s reaction to powerful anti-inflammatory drugs like prednisone or dexamethasone. These drugs mimic cortisol, the stress hormone your body makes naturally. But when you take them in pill or injection form, especially for weeks or longer, your liver starts pumping out more glucose, and your muscles and fat cells stop responding to insulin like they should. The result? Blood sugar climbs—even if you’ve never had diabetes before.

This isn’t just a side effect you can ignore. People with prediabetes, obesity, or a family history of type 2 diabetes are most at risk. A 2023 study in Diabetes Care found that over 30% of patients on daily oral steroids developed blood sugar levels high enough to need treatment. Even short courses, like a 5-day prednisone burst for asthma or allergies, can cause spikes that last days after the last pill. And if you’re already managing diabetes, glucocorticoid hyperglycemia can throw your whole plan off track—leading to fatigue, frequent urination, blurry vision, and worse.

It’s not just about the drug itself. cortisol, a natural hormone that regulates metabolism and stress response is the key player here. Steroids work by boosting cortisol’s effects, which means your body thinks it’s under constant stress. That triggers your liver to release stored sugar, while also blocking insulin from doing its job. This is why insulin resistance, a state where cells don’t respond properly to insulin shows up so fast. You’re not becoming diabetic because you ate too much sugar—you’re becoming diabetic because your body’s wiring got rewired by medication.

Thankfully, this isn’t a life sentence. Many people’s blood sugar returns to normal once they stop the steroids. But while they’re on them, you need a plan. Monitoring glucose levels at home, adjusting diet to limit refined carbs, staying active, and sometimes using short-term insulin or metformin can make a big difference. Your doctor might also lower the steroid dose, switch to a different type, or use inhaled versions instead of pills when possible.

The posts below give you real, practical advice from people who’ve dealt with this. You’ll find how hospitals manage blood sugar in patients on long-term steroids, what tests actually matter, how to talk to your doctor about alternatives, and why some people bounce back while others need ongoing care. No fluff. No theory. Just what works when your blood sugar spikes because of a medicine you need to take.