Steroid Induced Glucose Intolerance is a condition which is caused by the use of steroids, in which the body is unable to utilise Glucose as well due to the effects of cortisol from steroids that cause the body to become resistant to Insulin.
Steroids are used in the treatment of many diseases and disorders for their ability to reduce the inflammatory response and are generally well used in medium to short term doses.
Cortisol causes the body to be resistant to the effects of insulin. Insulin is a ligand (key) that allows the cells within the human body to absorb and utilise the sugar (glucose) found within the blood. Longterm use of steroids, which act on the hormone cortisol (found naturally within the human body), can cause patients to develop type 2 diabetes. This is because their cells no longer accepts sugar as readily as a normal healthy person from their blood supply and this leads to a higher resting blood glucose level (BGL) or blood sugar level (BSL).
In addition, cortisol also causes the liver, which stores large amounts of glucose in the form of glycogen, to secrete some of its glucose stores into the bloodstream. This in turn, further increases the resting blood glucose levels and leads to type 2 diabetes.
For paramedics and emergency doctors alike, steroid induced glucose intolerance is an important concept to understand because so many patients that we see are on long term steroids to treat a variety of their normal medical conditions and consequently are at risk of developing steroid induced glucose intolerance and type 2 diabetes. This is why some patients who are not known to have diabetes, but are on longterm doses of steroid based medications, need to have the blood glucose levels regularly assessed.