Can steroid asthma inhalers increase blood sugar?

Q. I have diabetes and asthma. For better asthma control, I should take the inhaled corticosteroid regularly. Will the inhaled corticosteroid cause a rise in my blood sugar?

A. Inhaled corticosteroids are used to treat asthma and chronic obstructive pulmonary disease (COPD). These medicines can raise blood sugar levels in someone with diabetes. It depends upon the dose of the inhaled corticosteroid, how much of the drug moves from the lungs to the bloodstream, and the person's sensitivity to any type of corticosteroid.

The higher the dose of inhaled corticosteroid, the greater the amount that gets absorbed through the lungs and passes into the bloodstream. But the actual amounts that get absorbed can vary quite a bit from one person to the next.

Also, people with diabetes can have different reactions to a corticosteroid. For example, some people with diabetes can take an oral corticosteroid (such as prednisone) by mouth and show little blood sugar change. Even low-dose prednisone in others will send their blood sugars wildly out of control.

Inhaled corticosteroids usually don't drive up blood sugars in people with diabetes. But even a standard dose in some people will cause high sugar levels.

Switching to a different brand probably will not make much difference in blood sugar control, assuming the new inhaler has equal corticosteroid potency. The potential of an inhaled corticosteroid to elevate blood sugar is similar no matter what the brand is. But lowering the dose could make it easier to control blood sugars.

It's always a balance of benefits and side effects. Good control of asthma or COPD may be your top priority. This might mean keeping your corticosteroid inhaler dose the same and increasing the dose of your diabetes medicine to help keep your blood sugars in line.

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