Articles, Blog

Drugs (medication) that Raise Blood Sugar Levels

August 24, 2019


Hello, I am Ty Mason of thediabetescouncil.com,
researcher, writer and I have type 2 diabetes. Today I want discuss drugs that raise blood
sugar levels. After you watch the video today, I invite
you check out the description box for my new ebook. This is one of the most comprehensive diabetes
meal planning book you can find. It contains diabetes friendly meals/recipes,
recipes for different goals such as 800-1800 calories per day meal plan, diabetes meal
planning tips and tricks. There are also tons of diabetes friendly recipes
for everyone! We all get sick from time to time. We all have been given prescriptions other
than our metformin or insulin. But did you know some medications can raise
your blood sugar? I am confident that somewhere in that plethora
of literature that accompanies most prescriptions is information that says that the drug will
affect blood sugar. But how many of us actually read all that
literature? Today I want to talk about common drugs that
can raise your blood sugar. This list was compiled after researching the
work of Mark T. Marino, MD. Corticosteroids
One class of medicines that has been shown to raise glucose levels is called the glucocorticoids. This includes such drugs as prednisone, dexamethasone,
and triamcinolone. These drugs are called glucocorticoids because
they have a profound effect on carbohydrate metabolism. They also have very powerful anti-inflammatory
effects and are usually reserved for serious medical conditions that require a substantial
reduction in inflammation, such as rheumatoid arthritis, severe asthma, or inflammatory
bowel disease. Corticosteroids counteract the effect of insulin
on the liver and stimulate the production of glucose. They also block the entry of glucose into
the muscles and fat tissue by preventing glucose-transport proteins in the cells of those tissues from
reaching the cell membrane, where they normally serve to remove glucose from the blood. These drugs have many other serious side effects,
including osteoporosis, suppression of the adrenal glands, and cataracts. For these reasons, they are only used when
the possible benefits outweigh the risks. Many of these drugs are now available in an
inhaled form for asthma or an intranasal form for allergies. These forms of delivery are associated with
far fewer side effects than oral forms, including those related to the body’s use of glucose. Thiazide diuretics
High blood pressure is itself a significant risk factor for Type 2 diabetes, but some
of the drugs used to treat it also appear to raise the risk of developing diabetes. Thiazide diuretics are a class of drugs that
treat high blood pressure by blocking the reabsorption of sodium in the kidneys. As part of this process, potassium is also
lost in the urine. This results in a lower level of potassium
in the blood, a condition known as hypokalemia. Many people who take this type of blood-pressure-lowering
drug also need to take potassium supplements to keep their blood levels of potassium in
the normal range. As noted earlier, potassium levels are closely
linked with both insulin secretion and glucose uptake into muscle and fat tissue. Multiple studies have looked at the effect
of thiazide diuretics on blood glucose levels, and the majority suggest that these drugs
tend to raise blood glucose. The most recent study was ALLHAT (Antihypertensive
and Lipid-Lowering Treatment to Prevent Heart Attack Trial). In this trial, whose results were published
in 2006, participants were given one of several different types of medicine to treat their
high blood pressure, to try to determine the best type of therapy. Based on a subgroup analysis of approximately
18,000 people without diabetes who were treated and followed for an average of five years,
the risk of developing diabetes was slightly higher in those who took a thiazide diuretic
(14%) compared to those who took two other types of blood-pressure-lowering drugs, a
calcium channel blocker (11.1%) or an angiotensin-converting enzyme (ACE) inhibitor (9.5%). While this difference may seem small, when
these percentages are applied to the millions of people with high blood pressure, many more
will develop diabetes on a thiazide diuretic than on a different type of drug. However, choosing a drug to treat high blood
pressure is not a simple issue, since ALLHAT also showed that thiazide diuretics were superior
to or equally as effective as other classes of blood-pressure-lowering drugs in people
with diabetes. When ALLHAT investigators specifically looked
at study participants who had diabetes, they found that these people tended to do well
on thiazide diuretics but also had, on average, a small increase in blood glucose (5 mg/dl). Many other large studies have also noted this
effect. The risk of developing diabetes while taking
a thiazide diuretic was also evaluated in the Nurses’ Health Study I and II as well
as the Health Professionals Follow-Up Study. Between the two studies, a total of 74,816
people who initially did not have diabetes were evaluated. Over the course of treatment with a thiazide
diuretic, the risk of developing diabetes was 20% higher in older women (average age
62), 51% higher in younger women (average age 40), and 31% higher in men compared to
those in the studies not taking a thiazide diuretic. However, there is evidence that when hypokalemia
(low blood potassium) in these people is corrected, blood glucose control improves. The takeaway message is that thiazide diuretics
are considered a good first choice for treatment of high blood pressure because they are effective,
cause few side effects, and are inexpensive, but certain individuals may develop diabetes
or experience difficulty controlling blood glucose while on a thiazide diuretic. Potassium levels should be monitored and corrected
when necessary. Beta-blockers
Beta-blockers are the other major class of blood-pressure-lowering drugs that have been
implicated in causing diabetes or worsening diabetes control. The several large studies that have looked
at the risk of diabetes associated with beta-blockers include the Nurses Health Studies I and II
and the ongoing ARIC (Atherosclerosis Risk in Communities) study. In these two studies, the risk of developing
diabetes in people originally without it who took beta-blockers was approximately 20% to
28% greater than in those who did not take beta-blockers. This may seem counterintuitive since people
with diabetes are often warned that beta-blockers can cause problems with low blood glucose,
not high blood glucose. Beta-blockers cause these two problems in
distinct ways. First, they may harm a person’s ability
to recognize and respond to low blood glucose, mainly by keeping the heart rate slow, which
can dampen symptoms of hypoglycemia. They may also inhibit the release of glucose
from the liver. But beta-blockers also block the release of
insulin by interacting with nerve signals to the pancreas and can thus lower insulin
levels even when blood glucose is high. There is some evidence that not all beta-blockers
affect insulin secretion. Beta-blockers work by interacting with proteins
in the body called beta receptors. There are several distinct types of beta receptors
in the body. Beta-1 receptors are predominantly in the
heart, while beta-2 receptors are in the heart as well as the arteries, muscles, liver, and
pancreatic beta cells. This means that beta-1–selective drugs are
less likely to interfere with the secretion and regulation of insulin. Several studies have shown that a combination
of beta-blockers and thiazide diuretics, as expected, also produces an increase in the
risk of developing diabetes, by approximately 20%. The National Institute for Health and Clinical
Excellence in the United Kingdom, an advisory group that develops national health policy,
has placed a limited caution against the combined use of beta-blockers and thiazide diuretics
for people at high risk for diabetes (because of family history, impaired glucose tolerance,
or obesity, for example). While the risk of diabetes-related complications
for the population as a whole is relatively low, these drugs may be a source of preventable
diabetes or of diminished blood glucose control in individual cases. Of note, ACE inhibitors and calcium channel
blockers have not been strongly linked to diabetes. Niacin Nicotinic acid, or niacin, is a B vitamin
commonly used to lower blood lipids (fats). It can reduce low-density lipoprotein (LDL,
or “bad”) cholesterol and triglycerides and also raise high-density lipoprotein (HDL,
or “good”) cholesterol. The combination of elevated LDL cholesterol
and triglycerides with low HDL cholesterol is a common lipid profile in people with diabetes. While the drug has many side effects, one
of the more important ones is worsening blood glucose control. However, data on the effect of niacin on blood
glucose control is not as plentiful as data on diuretics and beta-blockers. One well-controlled study of 148 people with
diabetes evaluated the effects of several different doses of niacin on both blood lipids
and blood glucose control. The goal of the study was to evaluate the
common medical practice of avoiding prescribing niacin to people with diabetes. Fasting blood glucose levels as well as glycosylated
hemoglobin (HbA1c, another measure of blood glucose control) levels were evaluated over
a 16-week period. While the doses of 1,000 mg and 1,500 mg of
niacin were effective for blood lipids, the higher dose resulted in an average increase
in HbA1c of 0.3 percentage points, and four people on niacin left the study due to its
worsening of blood glucose control. The conclusions of the study were that niacin
can be safely used in people who have diabetes, but that once again, in select individuals
it can have an adverse effect on blood glucose control. In another study, niacin was tested in combination
with simvastatin, another blood-lipid-lowering drug, in 160 people who had low HDL cholesterol
but normal LDL cholesterol. The investigators looked mainly at the progression
of lesions in coronary arteries, but they also evaluated blood glucose and insulin levels. Participants who received these two drugs
demonstrated a significant reduction in coronary artery lesions and heart attacks. They also, however, had elevated insulin levels
but not elevated blood glucose. This suggests that niacin may cause insulin
resistance, a condition in which the body does not use insulin efficiently. In a review article that examined trials of
niacin for both cardiovascular benefits and risks pertaining to diabetes care, it was
clear that niacin has significant and positive benefits for cardiovascular health (namely,
reduced heart attacks) but that small increases in blood glucose and insulin levels occur
that may require adjustments to diabetes therapy. Antipsychotic drugs Antipsychotic drugs are used to treat severe
psychiatric conditions such as schizophrenia. While schizophrenia is not a common disease
among people who have diabetes, among people with schizophrenia, there is a 15% prevalence
of diabetes and a risk of developing it two to three times that of the general population. Some of this risk may be due to family history,
poor diet, and physical inactivity. But recent evidence suggests that some drugs
used to treat schizophrenia may increase the risk of developing diabetes. A consensus statement from the American Diabetes
Association and the American Psychiatric Association recognizes that antipsychotic drugs, and in
particular olanzapine and clozapine, can elevate blood glucose, cause weight gain, and increase
blood lipids. These drugs also raise the risk for diabetic
ketoacidosis, an uncommon but extremely serious complication of diabetes. Several hypotheses have been proposed regarding
how these drugs may cause diabetes, from simply inducing weight gain to impairing insulin
secretion; but so far, no strong evidence explains why these drugs have this effect. Striking a balance There is a longer list of drugs associated
with diabetes, but the evidence for each of these is not very strong, or the medicine
is only used rarely. For the more commonly used drugs that are
known to worsen diabetes control, it is important to note that there remains a balance between
intended benefits and unwanted side effects. Glucocorticoids can stop an inflammatory process
like asthma, thiazide diuretics have been shown to be very successful at reducing high
blood pressure and its complications, beta-blockers do protect against heart attacks, niacin does
reduce coronary artery disease, and antipsychotic medicines can make the difference between
hallucinating and perceiving reality. If you suspect that your blood glucose control
may be adversely affected by a medicine you’re taking, speak with your health-care provider
before making any changes. There may be an overall benefit to remaining
on a drug that slightly increases blood glucose in some cases, or there may be alternatives
that can be substituted. Unfortunately, no medicine is without its
drawbacks, but by knowing what these drawbacks are, you can participate in an informed discussion
with your health-care provider about the specific risks and benefits of a drug in your unique
situation. Don’t forget to get my new ebook. Like this video and subscribe to our channel
so we can continue to bring you informative videos like this one in the future. Thanks for watching!

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6 Comments

  • Reply Beat Your Diabetes March 2, 2017 at 10:22 am

    Download Diabetes Diet eBook: https://goo.gl/UC5SZU

  • Reply Carolyn Mihelcic March 19, 2017 at 1:04 am

    That's Exactly what happened to me i took Med's right after i was Diabetic…

  • Reply Carolyn Mihelcic March 19, 2017 at 1:10 am

    Not taking Med's any more sugar is Normal HA…

  • Reply Noseefood June 17, 2017 at 6:22 am

    pls do metformin. if it's safe, effective, etc.

  • Reply S Larson August 16, 2017 at 9:37 pm

    Thank you for this video. Good information. I'm on a low dose, (10 mg.) of Lisinopril but without the thiazide.

  • Reply Amber Thor February 9, 2018 at 4:49 pm

    Thanks for the information. Very useful

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