There are benefits to taking inhaled corticosteroids to control your asthma symptoms. But did you know this medicine can put you at risk for diabetes? Before you skip your next puff, it's important to weigh in on all the facts to determine what's best for your situation.

The Connection

In the past, steroids were taken orally, which allowed the medication to travel throughout the entire body, but it caused serious side effects including elevated blood glucose levels often related to diabetes. This can occur as the result of several factors:

  • Steroids can prevent the release of insulin, causing insulin resistance.
  • Without insulin, the glucose is forced to remain in the blood stream instead of being transferred to the cells.
  • The steroids can prompt the liver to release extra glucose into the blood.

This combination of factors results in elevated blood glucose levels that the body may not be able to process.

Until recently, doctors believed that the best way to avoid this situation was to take an inhaled form of steroids, which go directly to the airways without impacting the rest of the body. However, a groundbreaking study included in the American Journal of Medicine in November 2010 revealed that even people taking inhaled steroids could be susceptible to this diabetes risk.

New Findings on Inhaled Steroids and Diabetes

A team of researchers from the Jewish General Hospital's Lady Davis Institute for Medical Research (LDI) in Montreal looked at health records of close to 4,000 people using inhaled corticosteroids for asthma and Chronic Obstructive Pulmonary Disease (COPD) and discovered that the medication caused an additional five people out of every thousand to be diagnosed with diabetes. This means that the annual rate of new diabetes diagnoses jumps from 14 people out of every thousand (the rate without the steroid involvement) to 19 people out of every thousand with inhaled steroid usage.

Weighing the Risk

While this may sound discouraging, the experts suggest that  before you forego corticosteroids, you need to weigh the benefits and risks.  For instance, if you suffer from asthma, the risks associated with not taking the medication can be even more serious. Therefore, for asthma, it's important to use your asthma control medications as directed.

On the other hand, for people with COPD, this medication doesn't seem to bring enough in the way of measurable improvements to outweigh the risks. If you have COPD, you should talk to your doctor about other, safer options.

What You Can Do

If you do use steroids, either in oral or inhaled form, be sure to have your blood sugar monitored regularly and be on the lookout for symptoms of diabetes or pre-diabetes. Some of the warning signs include increased thirst, more frequent urination, extreme hunger, unexplained weight loss, fatigue, an increase in infections, cuts that don't seem to heal, and tingling of the hands or feet. If you notice one or more of these symptoms, get a medical evaluation right away.

The side effects of inhaled steroids seem to increase with higher doses, so you'll want to use the lowest recommended dose that gives you the best asthma control results.


Faul, John L., et al. "The Effect of an Inhaled Corticosteroid on Glucose Control in Type 2 Diabetes." Clinical Medicine and Research, Volume 7, No. 1-2:14-20. 26 Feb. 2009. Web. 29 Nov. 2010.

"Inhaled steroids increase diabetes risk, study suggests." ScienceDaily. Jewish General Hospital, 1 Nov. 2010. Web. 11 Nov. 2010.

"Latest News and Info: Inhaled Steroids Linked to Risk of Diabetes." Defeat Diabetes Foundation, Inc. Defeat Diabetes Foundation, 27 Oct 2010. Web. 10 Nov. 2010.

Samy Suissa, Abbas Kezouh, Pierre Ernst. "Inhaled Corticosteroids and the Risks of Diabetes Onset and Progression." The American Journal of Medicine. 123 (11): 1001. Web. 11 Nov. 2010.

Slatore, Christopher G. et al. "The Association of Inhaled Corticosteroid Use with Serum Glucose Concentration in a Large Cohort."  The American Journal of Medicine. 122 (5): 472-478. Sept. 2008. Web. 29 Nov. 2010.

"Talking Diabetes No. 45: Steroids and Diabetes." Australian Diabetes Council. State/Territory Organisations of Diabetes Australia, Oct. 2008. Web. 29 Nov 2010.