The doctor says my son needs prednisone for an ongoing ear infection. I am worried because we have a family history of type 1 diabetes, and I have heard that prednisone can increase blood sugar levels. Can prednisone bring on diabetes in someone who could be incubating it but has not presented with the disease?

Prednisone is a glucocorticoid, which is to say that one of its properties is to mobilise glucose from protein in the body and thus to counterbalance the action of insulin which is to lower blood sugar. Thus, in situations where the supply of insulin is diminished or resistance to its action increased, prednisone can indeed hasten the onset of clinical diabetes. If the family history in your case is of type 2 diabetes, and the proposal is to use prednisone only briefly in association with placing tubes for a chronic otitis media, then I think that the risk is very small indeed. If however, the family history is of type 1A (autoimmune) diabetes and prednisone is planned for more than two or three weeks, you might want to talk to your son’s doctor about first getting an antibody test to find out if your son would be especially at risk.

DOB