Steroid diabetes is a fairly serious disease, which is a type of diabetes. 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 against the background of prolonged use of certain hormonal drugs, so it is called drug diabetes.
Who is affected?
Steroid diabetes refers to those diseases that are extrapancreatic in nature. That is, it is not associated with problems in the pancreas. Patients who have abnormalities in the process of carbohydrate metabolism, but who have been using glucocorticoids (hormones produced by the adrenal glands) for a long time, can become ill with steroid diabetes mellitus, which is mild.
Manifestations of the disease disappear after a person stops taking hormonal drugs. In sixty percent of cases among patients with type 2 diabetes, this disease leads to the fact that patients have to switch to insulin treatment. In addition, diabetes mellitus can develop as a complication of such diseases in which the production of hormones of the adrenal cortex increases, for example, hypercorticism.
What drugs can provoke drug diabetes?
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 cure 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.
In addition, drug diabetes can occur due to the use of hormonal birth control pills, as well as some thiazide diuretics, which are diuretics. These drugs include Dichlothiazide, Hypothiazide, Nephrix, Navidrex.
A few more causes of the disease
Steroid diabetes can occur in humans after a kidney transplant. Anti-inflammatory therapy after organ transplantation requires long-term administration of high doses of corticosteroids, so patients have to drink drugs for life to suppress immunity. 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 the cases they treat 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, regularly doing light physical exercises. If a person is predisposed to this disease, he is strictly forbidden to take hormones based on his own conclusions.
Specificity of the disease
Medicinal diabetes is characterized by the fact that it combines the symptoms of diabetes of both types. At the very beginning of the disease, corticosteroids in large quantities begin to damage beta cells that are located in the pancreas. This symptomatology is typical for diabetes 1. Despite this, the insulin in beta cells still continues to be injected. 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. Common insulin-dependent type 1 diabetes mellitus proceeds in a similar manner.
Symptomatology
Symptoms of steroid diabetes are the same as with other forms of diabetes. A person suffers from intense 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. In contrast to type 1 diabetes, patients do not have sudden weight loss. Doctors are not always able to diagnose diabetes mellitus even after a patient has taken a blood test. High sugar levels in urine and blood are extremely rare. Moreover, the limit figures for acetone in patient analyzes are also found in isolated cases.
How to heal when insulin is produced
When insulin production ceases in the human body, steroid diabetes is similar to diabetes of the first type, although it has the characteristic features of the second (tissue insulin resistance). This diabetes is treated in the same way as diabetes 2. Of course, it all depends on what kind of disorders in the body the patient suffers. If the patient has problems with excess weight, but insulin continues to be produced, then he should adhere to a diet and also use sugar-lowering drugs, for example, Thiazolidinedione or Glucofage.
When the pancreas begins to function worse, it is recommended to inject insulin, which will help reduce the burden on the organ. If beta cells have not completely atrophied, then after some time, the pancreas returns to normal. For the same task, doctors prescribe to patients a low-carb diet. Patients who do not have problems with excess weight should adhere to diet No. 9. For those who are overweight, doctors recommend diet No. 8.
Features of treatment when insulin is not produced
Treatment for steroid diabetes depends on whether or not pancreatic insulin is produced. If this hormone has ceased to be produced in the patient's body, then it is prescribed as an injection. In order for the treatment to be effective, the patient needs to learn how to properly administer insulin injections. Blood sugar concentration should be constantly monitored. The treatment of diabetes mellitus proceeds in the same way as in diabetes 1. But dead cells are no longer restored.
Non-standard situations
There are some individual cases of treatment for steroid diabetes, for example, with severe asthma or after kidney transplant surgery. In such cases, hormone therapy is necessary, although the patient develops diabetes. Sugar levels need to be maintained based on how well the pancreas works. In addition, specialists take into account the sensitivity 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 different ways. But not all people who take glucocorticoids are at risk for diabetes. Corticosteroids affect the functionality of the pancreas, reducing the strength of insulin. 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, this means that the tissues have become less sensitive to insulin, and it is difficult for the gland to cope with its duties.
The risk of developing diabetes mellitus increases when a person has an overweight problem, consumes steroids in large doses or for a long time. Since the symptoms of this disease do not appear immediately, elderly people or those who are overweight should be screened for the presence of a latent form of diabetes before starting hormone therapy, since taking some medications can provoke the development of the disease.