April 16, 2012
Hyperglycemia and DKA, Other Medications
Question from Ft. Worth, Texas, USA:
Two weeks ago, I went to the Emergency Room for what I thought was a severe asthma attack. After multiple nebulizers and no improvement, I was admitted to the intensive care unit (ICU) so they could treat the suspected asthma with steroids. I was later told I had pertussis and was in the ICU for a week. Now, I am told I will have to be on steroids for close to six months. My A1c has never been above 7.1 in the 11 years I have had diabetes and I am worried about what the steroids will do to me. Am I more prone to DKA now?
Answer:
The steroids will raise your blood sugars. Your body makes the equivalent of 20 mg hydrocortisone or 7.5 mg prednisone per day. If you are on doses above this, your blood sugars will be potentially higher and require an increase in your insulin. In addition, the steroids will cause you to gain weight and increase your appetite. I do not think the threshold for DKA is increased, but if the blood sugars are higher, this increases the chances. Your doctor will need to work with you to get onto the lowest effective dose for your needs.
JTL
