Information Leaflet
Irish National Liver Transplant Unit
Steroid Induced Diabetes
Steroid induced diabetes is a form of diabetes that results from taking high doses of
steroids.
What are steroids?
Steroids are drugs that are often used in medicine as they have a strong effect in
suppressing inflammation and various immune problems. They play a key role in
liver transplantation in assisting in the prevention and treatment of rejection. There
are several kinds of steroids, such as the ones used in muscle building (anabolic or
androgenic steroids) but the ones used in transplantation are called corticosteroids e.g.
the drug prednisolone.
Corticosteroids are essential hormones made in the adrenal glands and are part of the
“fight or flight” response that also includes adrenaline.
Who is most at risk of developing steroid induced diabetes?
Steroids increase the blood sugar level of people who have diabetes and they may
cause or uncover diabetes in many people who don’t yet have it. Those people who
are most at risk of developing steroid induced diabetes are those who have a family
history of diabetes, those who are overweight, those who take little exercise and
people over 40 years of age.
Why does taking steroids cause diabetes?
One effect of corticosteroids is that they counteract the effect of insulin, another
hormone made in the pancreas, which helps the body burn sugar for energy.
If your pancreas is strong and able it will produce more insulin when you are taking
steroids and your blood sugar will remain normal. If your pancreas is not so strong
(insulin challenged) it can not produce enough insulin and can not keep the blood
sugar normal. When the blood sugar goes up in this case, the condition is called
steroid induced diabetes.
The good news is that when the dose of steroids is reduced or they are stopped
altogether, the diabetes may well go away.
Why is diabetes a problem?
Elevated blood sugars are abnormal. In the short term they can cause unpleasant
symptoms such as tiredness, thirst, frequent passing of urine and importantly they can
also predispose to infection and delay healing. In the long term, elevated blood sugars
can cause increased risk of heart attacks, strokes and circulation problems,
particularly to the feet.
How is it diagnosed?
It is easily diagnosed by measurement of sugar levels in a blood test(s).
How is it treated?
The aim of treatment is to lower the blood sugar with diet and either tablets or insulin.
Each person is assessed individually and the appropriate treatment is decided between
the patient and their medical teams.
Many people require insulin. Insulin is given by a “pen style” injection device that is
very user friendly. For most people this treatment is a temporary measure, because as
steroid dosage is reduced and withdrawn, blood sugars usually revert to normal
levels.
Self-monitoring of blood sugar levels is very important. This is done in hospital and
at home by regular fingertip testing using a small, portable, easy to use meter.
Who will teach me about diabetes?
While in hospital you will meet regularly with a diabetes nurse specialist and a
dietician who will guide and support you in learning about controlling diabetes,
testing your blood and administering treatment.
Patients usually keep in contact with the Diabetes Centre for support and advice for as
long as they require. The contact number is (01)2094527.
This leaflet has been developed by the Liver Transplant Co-ordinators and the
Diabetes Nurse Specialists
September 2003