Corticosteroid Hyperglycemia: What It Is, Why It Happens, and How to Manage It

When you take corticosteroid hyperglycemia, a rise in blood sugar caused by corticosteroid medications like prednisone or dexamethasone. It's not diabetes, but it acts like it—because your body can't handle the flood of glucose these drugs trigger. This isn't rare. Up to 30% of people on long-term steroids develop elevated blood sugar, and for some, it’s sudden and severe. You might not feel it at first, but unchecked, it can lead to fatigue, frequent urination, blurry vision, and even hospitalization.

This isn’t just about diabetes meds. corticosteroids, powerful anti-inflammatory drugs used for asthma, arthritis, lupus, and even severe allergies interfere with how your liver releases sugar and how your muscles and fat cells use insulin. Your pancreas tries to keep up, but it gets overwhelmed. Even short courses—like a 5-day prednisone taper—can spike glucose in people who never had issues before. And if you’re already prediabetic or overweight, the risk jumps even higher.

insulin resistance, a condition where your cells stop responding well to insulin is the hidden driver here. Steroids make your cells ignore insulin’s signal, so sugar piles up in your blood. That’s why some people on steroids need insulin—even if they’ve never taken it before. It’s not a failure. It’s your body adapting to a chemical flood.

What’s surprising is how many people don’t know this is happening. Doctors often focus on the condition being treated—like a flare-up of rheumatoid arthritis—and forget to check glucose levels. But if you’re on steroids for more than a few days, you should be monitoring. A simple fingerstick test twice a day can catch problems early. And if your sugar stays above 180 mg/dL, talk to your doctor. You might need a short-term insulin plan, a change in steroid dose, or just better timing of meals and meds.

It’s not all bad news. Most of the time, blood sugar returns to normal once you stop the steroids. But during treatment, small changes make a big difference. Skip sugary drinks. Eat protein and fiber with every meal. Avoid large carb-heavy meals. Walk after eating. These aren’t fancy fixes—they’re basic moves that help your body cope.

You’ll find real stories in the posts below: how someone managed high sugar while on prednisone for a COPD flare, what worked when metformin didn’t, why timing meals around steroid doses matters, and how some patients avoided insulin altogether with diet and activity alone. These aren’t theory—they’re lived experiences from people who’ve been there.