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Diabetes

Diabetes and prednisone

09/10/2008

Question:

I have adrenal insufficiency and have been on prednisone for 35 years. About 5 years ago I was diagnosed with Diabetes. Is there another drug besides prednisone I can take? It raises my blood glucose every night!

Answer:

There are a number of different drugs which are similar in function to prednisone which is itself a drug substitute for the adrenal hormone cortisol.  The key issue is that the activity of prednisone which is treating the adrenal insufficiency is precisely the same activity which causes blood sugar to be high:  the various drugs related to prednisone differ in their time course of action and in their potency.  The trick in your situation is picking the right form and adjusting the dose as precisely as possible to get the best trade-off between the beneficial and detrimental effects.  Endocrinologists are the specialists who have the most expertise in advising people on those trade-offs and trying to find the optimum choice of drug form and dose - perhaps you need to see an endocrinologist.  If you live in or near Ohio, check out the NetWellness physician directory.  Otherwise, see directories for the Endocrine Society or the American Association of Clinical Endocrinologists.

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Response by:

Robert M Cohen, MD Robert M Cohen, MD
Professor of Clinical Medicine
College of Medicine
University of Cincinnati