When type 2 diabetes creeps into your life, it usually isn’t alone. It often brings other health problems with it, and these complications may require treatment.
“One of the challenges that we face is that many patients with diabetes also have other conditions, such as high blood pressure and high cholesterol, and those conditions require medication that can raise blood glucose levels,” says Eva M. Vivian, PharmD, professor of pharmacy at University of Wisconsin–Madison School of Pharmacy.
But just because a medication can raise your blood sugar doesn’t mean that you shouldn’t take it. Still, you should be aware of the possibility, and work with your doctor to find the best approach for you.
Let’s look at some of the most common meds that can affect blood sugar control:
1. Corticosteroids to Lower Inflammation in Arthritis, Asthma, Allergies, and Joint Injuries
These drugs are used to treat many conditions associated with inflammation, including arthritis, asthma, allergies, and joint injuries. Corticosteroids used in inhalers or skin creams aren’t likely to affect blood glucose because they don’t enter the blood stream in great enough quantities. But those that are injected or ingested by mouth can significantly increase blood glucose, says Timothy In-Chhu Hsieh, MD, chief endocrinologist at the Kaiser Permanente West Los Angeles Medical Center in California.
"If it's only a short-term treatment, there won't be too long of an effect and it may not influence things a great deal, but if it's being used for several days or weeks, then the sugar level can go higher and be a significant problem," he says. If that’s the case, you can work with your doctor to adjust your diabetes medication to keep glucose under control.
2. Beta-Blockers for Conditions Such as Arrhythmia and Anxiety
This large class of drugs is used to lower blood pressure and treat a variety of other conditions, including irregular heartbeat and anxiety, but they can also raise your blood sugar levels. Some beta-blockers have less of an effect on blood glucose than others, Dr. Vivian says, but these are sometimes more expensive and may not be covered by insurance.
Also, important to note, beta-blockers can mask tachycardia associated with hypoglycemia, or low blood sugar.
Dr. Hsieh says that for many conditions, there are alternatives to beta-blockers that might be used instead for people with type 2 diabetes. But if not, “you take the good with the bad and do what you need to, in terms of intensifying the diabetic treatment,” he says.
3. Statins to Help Lower LDL, or ‘Bad,’ Cholesterol Levels
Statins are used to lower LDL, or “bad,” cholesterol levels and can be a vital therapy for preventing heart disease and stroke. But they can also increase blood sugar levels, and for people with prediabetes, using a statin is linked with a greater risk of developing full-blown diabetes. A study published in October 2017 in the journal BMJ Open Diabetes and Research Care, which tracked people with prediabetes for 10 years, found that statin use was associated with a 30 percent higher risk of developing diabetes.
But both Hsieh and Vivian emphasize that heart attack and stroke are major killers for people with diabetes, and there aren’t suitable alternative drugs for statins. “The benefits of heart attack and stroke prevention far outweigh the risk of elevated blood glucose levels,” Vivian says.
4. Niacin to Bring Down Bad Cholesterol
Niacin is a B vitamin available as an over the counter (OTC) supplement. It can have cholesterol-lowering effects, but like statins, it can also raise blood glucose in people with diabetes. A study published in February 2016 in the journal Heart also concluded that niacin increases the risk of developing diabetes in the first place.
5. Antipsychotics to Treat Mental Illnesses, Such as Schizophrenia
Certain antipsychotic drugs, which are used to treat schizophrenia and other mental illnesses, can increase your blood sugar levels. “Those medications are typically used for months or years at a time, so that is definitely an issue to be aware of,” Hsieh says.
But a study published in May 2016 in the journal Schizophrenia Bulletin found that among schizophrenia patients with newly diagnosed diabetes, those who took antipsychotics ended up with fewer advanced diabetes complications, despite the potential for these drugs to increase blood sugar. “A possible explanation is that antipsychotic treatment can improve the patient’s physical, psychosocial, and self-care functioning, thereby enhancing healthy behaviors and decreasing the risk of diabetes complications,” the authors write.
6. Certain Antibiotics to Address Infections, Such as UTIs and Pneumonia
A class of antibiotics called fluoroquinolones, used to treat illnesses like pneumonia and urinary tract infections (UTIs), has been shown to cause both very low and high blood sugar, a study published in October 2013 in the journal Clinical Infectious Diseases found. In addition, pentamidine, an antimicrobial drug used to treat a certain kind of pneumonia, can also cause a rise in blood sugar.
7. Decongestants Used to Offer Relief from the Common Cold or Flu
Decongestant medicines, including Sudafed (pseudoephedrine) and phenylephrine, can increase your blood sugar levels. Both are available over the counter, although medication with pseudoephedrine has to be requested from a pharmacist. Many common decongestants use one of these ingredients, so check labels carefully. Short-term use of these is probably okay but check with your doctor first.
Tips for Managing Medication That Affects Blood Glucose
Despite these risks, you may find yourself needing to take one of these drugs while managing diabetes. Fortunately, you can take a few steps to help keep your blood sugar controlled, including the following:
Pause before immediately taking a new medication. “Patients should always consult the pharmacist or their doctor before they start any new over-the-counter medication,” Vivian says.
Clear it with your main diabetes doctor. If a specialist, like an orthopedist or psychiatrist, prescribes a new medication, check in with your certified diabetes educator or primary care doctor to ensure that it’s okay to take and to coordinate any necessary adjustments to your diabetes medication, Hsieh says.
Take care of yourself. Prioritize diet and exercise if you’re taking a medication that may affect your blood sugar control. “Physical activity and healthy nutrition help to prevent as significant of a spike, so we may not have to make an aggressive change in the medication regimen,” says Vivian.
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