My grandchild was just diagnosed with diabetes. She had been on steroid medicines, Decadron and Flovent. Her blood sugars went up to 500 mg/dl [27.8 mmol/L] for a glucose tolerance test. Ever since we took her off the Flovent and Decadron, her blood sugars have been normal. What is an islet test and how accurate is it? It seems like the longer she has been off the medications, the longer she is in the normal range. Could this be something that would ever maintain with proper eating and exercise?

Steroids are extremely useful and powerful medications to stop inflammation, but sometimes they also interfere or block how insulin works. Some children and adults treated with steroid have so much insulin resistance that their own pancreas cannot counterbalance sufficiently, so diabetes develops. Sometimes this is just a coincidence with an illness precipitating development of diabetes. Off steroids, if the blood glucose levels are normal, then this may be a temporary situation. If there is underlying autoimmune disease of the pancreas, antibodies will be positive. The islet cell antibody, GAD65 antibody and insulin antibody tests look for such evidence of inflammation and may predict what is likely to happen with beta cell function. Go back and discuss this in more detail with your diabetes team since they can give you more specific information about your child.

SB