Understanding What You Should Know About Drug-Induced Hyperglycemia

What You Should Know About Drug-Induced Hyperglycemia

hyperglycimiaLearning to manage diabetes, including episodes of high blood sugar (hyperglycemia), is an important part of an overall plan to take control of your health and to reduce the risks of complications such as eye, kidney, feet and heart disease. Leading a healthy lifestyle by avoiding smoking, exercising, controlling weight, blood pressure and cholesterol has been shown to decrease complications associated with diabetes.

The American Diabetes Association defines hyperglycemia as excessive blood glucose. Signs and symptoms of hyperglycemia may include increased blood pressure, increased heart rate, urination, thirst, fatigue and confusion. Signs and symptoms may be different for each person. If hyperglycemia occurs frequently or persists, diabetes may not be properly controlled.

Many medications increase blood glucose, or cause hyperglycemia. This is especially important to patients who are already having difficulty controlling their diabetes. It is difficult to predict when and if these medications will cause hyperglycemia and every person is different. It may occur after the first dose or even days or years after beginning a medication.Just because these medications can increase blood sugar levels, it doesn’t mean they should be avoided in patients with diabetes. Sometimes these drugs are critical and need to be taken. Patients can work with their providers to adjust their diabetes medications if needed. Checking your blood glucose regularly, recognizing the signs and symptoms of hyperglycemia, and knowing when and how to manage elevated blood glucose may help to limit or avoid episodes of severe hyperglycemia.

Below are examples of medications associated with hyperglycemia in patients with diabetes. It does not include all medications that may have this effect.
Common classes of medications include corticosteroids (steroids), HIV antiretrovirals, certain antipsychotics, some blood pressure medications, estrogen, progestin and anti-androgen hormones, immune suppressants, antibiotics, and decongestants.

Acetazolamide Dexamethasone Olanzapine
Albuterol Everolimus Prednisolone
Alcohol Fosamprenavir Prednisone
Atenolol Hydrochlorothiazide Phenylephrine
Bicalutamide Levofloxacin Propranolol
Chlorthalidone Megestrol Pseudoephedrine
Clozapine Methylprednisolone Ritonavir
Conjugated Estrogen Metoprolol Sirolimus
Contraceptives (Hormonal) Moxifloxacin Tacrolimus
Cyclosporine Niacin

In patients with diabetes, certain medications may worsen glucose control.When starting any new medication, prescription or over the counter, or if having trouble managing diabetes, speak with your doctor or pharmacist about medications that might contribute to hyperglycemia. Consult with a diabetes educator for advice on an overall plan to manage your diabetes.

This article is brought to you by our guest writers:
Kathy Grams, PharmD Assistant Professor of Pharmacy Practice, MCPHS University-Boston
Suzanne Dinsmore PharmD, CGP Assistant Professor of Pharmacy Practice, MCPHS University-Boston
Jennifer Goldman, PharmD, CDE, BC-ADM, FCCP Professor of Pharmacy Practice, MCPHS University-Boston, Clinical Pharmacist, Well Life Medical, Peabody, MA

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