How Prolonged Prednisone Use Led to Diabetes for Me
While medically necessary, steroids have caused complications for this columnist
I never thought I’d say this, but it’s my reality: I’m a diabetic.
It’s hard to admit this is a part of my life now. Like most aspects of my health, my diabetes is atypical. It didn’t stem from a bad diet or excessive sugar intake, as most people tend to assume. My diabetes is a result of medically necessary prednisone usage.
In honor of World Diabetes Day on Nov. 14, I want to educate others about this disease to help bridge the gaps in understanding. For instance, it’s important to know that there are different types of diabetes that may be caused by various factors, such as genetics, an autoimmune reaction, or medication side effects. Awareness can help decrease judgment toward people with diabetes, as the condition can often result from circumstances outside of one’s control.
After struggling with cystic fibrosis (CF) my whole life, I once again have an invisible illness that’s hard for others to understand. I have a sensor on my arm to monitor my blood sugar, and many people are surprised when they learn what it’s for. Puzzled, confused looks are as natural as bowel movements to me. I usually don’t look sick, but I definitely feel it.
In recent years, there’s been more awareness about CF-related diabetes, which occurs when thick mucus scars the pancreas, preventing it from producing enough insulin. I’ve been misdiagnosed with this in the past. Some providers assumed that my irregular blood sugar levels were simply a result of my CF.
But I didn’t have issues with my blood sugar until I started taking prednisone. Like other steroids, prednisone can cause elevated blood sugar levels, and over time, this can lead to diabetes. Prior to my double-lung transplant five years ago, I took several rounds of prednisone to help reduce my lung inflammation. Every time, my blood sugar would spike, but the problem was remedied once I finished the course.
Immediately after my transplant surgery, I was on high doses of steroids to suppress my immune system and prevent organ rejection. Starting with 500 mg of prednisone and tapering down over the course of several months took a toll on my blood sugar. Since prednisone is one of my anti-rejection medications, it’s vital for me to take on a daily basis.
Unfortunately, this caused my blood sugar levels to be consistently high and out of control, so I had to start taking insulin.
I wasn’t prepared to receive a new diagnosis, deal with new symptoms, and adjust to new routines post-transplant. High blood sugar levels made me angry, tired, and irritable. I snapped at loved ones, was super anxious, and felt like there was power surging through my entire body. Having to deal with these symptoms on top of tremendous pain from surgery was a rude awakening. I didn’t want monitoring my blood sugar and administering insulin to be my new normal.
I was determined to get off insulin, even though medical professionals told me it wouldn’t happen. Six months after my transplant, with diligent exercise and nutritional changes, I met my goal. My providers said I’d proved them wrong. It was a victory.
Unfortunately, due to my continued prednisone use, blood sugar issues have caught up to me again, resulting in diabetes. I had to start using insulin again this past spring, though at a minimal degree. Thankfully, I only need to take long-acting insulin in the morning and am able to continue controlling my blood sugar through diet and exercise the rest of the day. I tailor my diet to prevent high blood sugar levels, as I prefer to take the lowest amount of insulin possible.
My diabetes educator and endocrinologist are exceptional. They’ve taught me it’s not my fault that my blood sugar levels are spiking; it’s just a side effect of my medication. And fortunately, my pancreas is still working. It just needs a little help with the late-afternoon blood sugar spikes that are consistent with prednisone.
This knowledge has been vital for my success, as I’m typically hard on myself and want to fix whatever’s wrong with my body. Understanding that my blood sugar levels would be normal if it weren’t for prednisone has helped me accept the necessary usage of insulin.
Prednisone-induced diabetes is relatively common in transplant recipients. Taking medication to protect our new organs is a double-edged sword. Yes, diabetes adds stress and extra steps to my daily routine. No, I’m not drowning in self-pity. It’s been a learning curve, but managing this condition is necessary to stay as healthy as possible. It also helps to know that I’m not alone: My friends are facing this diabetic curveball alongside me.
Note: Cystic Fibrosis News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Cystic Fibrosis News Today or its parent company, BioNews, and are intended to spark discussion about issues pertaining to cystic fibrosis.