Steroid diabetes is a rather serious disease, which is a type of diabetes mellitus. Its other name is secondary insulin-dependent type 1 diabetes. The disease requires a serious attitude on the part of the patient. This type of diabetes can develop on the background of long-term use of certain hormonal drugs, so it is called drug-induced diabetes.
Who is affected?
Steroid DM refers to those diseases that are extrapancreatic in nature. That is, it is not associated with problems in the pancreas. Patients who have abnormal carbohydrate metabolism but have taken glucocorticoids (hormones produced by the adrenal glands) for a long time may develop mild steroid diabetes.
Manifestations of the disease disappear after a person stops taking hormonal drugs. At sixtypercent of cases among patients with type 2 diabetes, this disease leads to the fact that patients have to switch to insulin treatment. In addition, drug-induced diabetes can develop as a complication of diseases in which a person's production of hormones of the adrenal cortex increases, for example, hypercortisolism.
What drugs can cause drug-induced DM?
The cause of steroid diabetes can be long-term use of glucocorticoid medications, which include Dexamethasone, Prednisolone, and Hydrocortisone. These drugs are anti-inflammatory drugs that help treat bronchial asthma, rheumatoid arthritis, as well as some autoimmune diseases, which include pemphigus, lupus erythematosus and eczema. Also, these medicines are used to treat such a serious neurological disease as multiple sclerosis.
Also, drug-induced DM can result from the use of hormonal birth control pills, as well as some thiazide diuretics, which are diuretics. These drugs include Dichlothiazide, Hypothiazide, Nefrix, Navidrex.
A few more causes of the disease
Steroid diabetes can also appear in a person after a kidney transplant. Anti-inflammatory therapy after organ transplantation requires long-term administration of corticosteroids inhigh doses, so patients have to take drugs for life to suppress the immune system. However, steroid diabetes does not occur in all patients who have undergone such a severe surgical intervention, but the likelihood is much higher due to the use of hormones than in cases of treatment of other diseases.
If a person has been using steroids for a long time and he has signs of diabetes, then this indicates that the patient is at risk. To avoid steroid diabetes, overweight people should lose weight and change their lifestyle by engaging in regular light exercise. If a person is predisposed to this disease, he is strictly forbidden to take hormones based on his own conclusions.
Specific disease
Drug-induced diabetes is characterized by the fact that it combines the symptoms of both types of diabetes. At the very beginning of the disease, corticosteroids in large quantities begin to damage the beta cells that are located in the pancreas. Such symptoms are typical for type 1 diabetes. Despite this, insulin in beta cells still continues to be processed. After some time, insulin levels begin to decline, and tissues become less sensitive to this hormone. These symptoms are characteristic of type 2 diabetes. Over time, beta cells begin to break down. As a result, insulin production stops. The usual insulin-dependent diabetes mellitus of the first type proceeds in a similar way.
Symptomatics
Symptoms of steroid sugardiabetes are the same as in other forms of diabetes. A person suffers from increased and frequent urination, he is tormented by thirst, and a feeling of fatigue appears very quickly. Such signs of the disease are usually mild in patients, so they rarely pay attention to it. Unlike type 1 diabetes, patients do not experience sudden weight loss. It is far from always possible for doctors to diagnose drug-induced diabetes even after a patient has given a blood test. High levels of sugar in urine and blood are extremely rare. Moreover, the limiting numbers of acetone in the patient's analyzes are also found in isolated cases.
How to heal when insulin is being produced
When the production of insulin stops in the human body, steroid diabetes is similar to type 1 diabetes, although it has the characteristic features of the second type (insulin resistance of tissues). This diabetes is treated in the same way as type 2 diabetes. Of course, it all depends on what disorders the patient suffers from in the body. If the patient has problems with being overweight, but insulin continues to be produced, then he should follow a diet, as well as use sugar-lowering drugs, such as Thiazolidinedione or Glucophage.
When the pancreas began to function worse, it is recommended to inject insulin, which will help reduce the load on the organ. If the beta cells have not yet completely atrophied, then after some time the work of the pancreas returns to normal. For the same task, doctors prescribe patients a low-carbohydrate diet. Sick,who do not have problems with being overweight should follow diet number 9. For those who are overweight, doctors recommend diet number 8.
Features of treatment when insulin is not produced
Treatment of steroid diabetes depends on whether insulin is produced by the pancreas or not. If this hormone has ceased to be produced in the patient's body, then it is prescribed in the form of injections. For the treatment to be effective, the patient needs to learn how to properly inject insulin. The concentration of sugar in the blood must be constantly monitored. Drug-induced diabetes is treated in the same way as in type 1 diabetes. But dead beta cells cannot be restored.
Unusual situations
There are some isolated cases of treatment of steroid diabetes mellitus, for example, in severe asthma or after kidney transplant surgery. In such cases, hormone therapy is necessary, although the patient develops diabetes. Sugar levels should be maintained based on how well the pancreas works. In addition, experts take into account the susceptibility of tissues to insulin. In these situations, patients are prescribed anabolic hormones, which are additional support for the body, and also balance the effect of glucocorticoids.
Risk factors
A person has a certain amount of adrenal hormones, the level of which varies in each person in different ways. But notall people who take glucocorticoids are at risk of developing drug-induced diabetes. Corticosteroids affect the functionality of the pancreas by reducing the strength of insulin action. In order to maintain a normal concentration of sugar in the blood, the pancreas must cope with heavy loads. If the patient has symptoms of steroid diabetes, then this means that the tissues have become less sensitive to insulin, and the gland is difficult to cope with its duties.
The risk of developing drug-induced diabetes increases when a person has a problem of excess weight, uses steroids in high doses or for a long time. Since the symptoms of this disease do not appear immediately, older people or those who are overweight should be examined for the presence of a latent form of diabetes before starting hormone therapy, as taking certain medications can trigger the development of the disease.
