Pulmicort and Blood Sugar

Content provided by the Faculty of the Harvard Medical School

Pulmicort and Blood Sugar

Question:

I have type 1 diabetes. Could Pulmicort (an inhaled corticosteroid used to treat asthma and chronic obstructive pulmonary disease) cause a rise in my blood sugar?

Answer:

Pulmicort could raise blood sugar levels in someone with diabetes. It depends upon the dose of the inhaled corticosteroid, how the person's lungs absorb the drug and the person's sensitivity to all corticosteroids.

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

Also, some people with diabetes can take oral corticosteroids (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. This happens less often with inhaled corticosteroids, but definitely can occur.

Switching from Pulmicort 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 and chronic obstructive pulmonary disease may be more important than needing to change your diet or increase your insulin dose.

Howard LeWine, M.D., is chief editor of Internet Publishing at Harvard Health Publications. He is recognized as an outstanding clinician and teacher and is a recipient of the Internal Medicine Teacher of the Year award at Brigham and Women's Hospital. Dr. LeWine continues to practice Internal Medicine; most recently he became a hospitalist after practicing primary care for over 20 years.

Last updated:	July 20, 2009