The confusion arises because it is not an autoimmune disease and yet it can sometimes have total beta cell failure.
It comes about from the taking of steroids over a long period of time. Not the steroids used by weight lifters but those often medically prescribed, the corticosteroids or glucocorticoids, such as hydrocortisone, prednisone or dexamethasone.
They are used to suppress inflammation in diseases such as arthritis, to treat asthma, immune system diseases like Lupus or pemphigus (a rare autoimmune blistering diseases of the skin) down to skin problems like eczema and poison ivy and neurological diseases such as multiple sclerosis.
Another area where steroid induced diabetes is commonly seen is in patients who have had kidney transplants. The amount of steroids necessary to suppress the immune system and lessen the chance of organ rejection can lead to diabetes.
How does the taking of steroids cause diabetes?
Corticosteroids counteract the effect of insulin, which makes your pancreas work harder pumping out more insulin to keep your blood sugar normal. Normal pancreases do this quite happily but if you pancreas works a bit 'on the edge' so to speak, it cannot cope with this demand for extra insulin and your blood sugars go up. In other words your pancreas is okay normally but cannot handle the stress of the steroids.
Not all people treated with steroids will get steroid - induced diabetes.
The risk goes up if the following factors are present:-
1. Long use.
2. High doses.
3. There is a family history of type 2 diabetes.
4. You are overweight.
5. You have a history of high blood sugar.
While on steroids it may help to reduce the risk by:-
1. Regular exercise. Whatever and as much as you can manage, considering that you are taking steroids for something that may make this difficult.
2. Eat a healthy diet.
3. Try and keep your weight correct.
These are the same as other types of diabetes, the main ones being:-
2. Frequent urination
3. Unexplained weight loss.
Depending on the severity this will be the same as for other types of diabetes, either by diet, oral medication or insulin.
For most people the good news is that once they reduce or stop the steroids the problem will go away. They have also received the warning that they have an 'at risk' pancreas and can act upon that knowledge.
However in some unfortunate people the beta cells of the pancreas have been destroyed to the point where there are not enough left and they now have diabetes for life and need injected insulin.
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