Thoughts from a Doc: Why do my sugars DO that?!? (Part 2)

Today's post comes from Dr. Stuart Chipkin, Valley Medical Group's Endocrinologist and Diabetes Program Director. 

This is Part 2 of 3 of this series from Dr. Chipkin. Last week we heard his thoughts on how exercise and food impact blood sugars - this week we get his perspective on some medications that can influence your numbers. 

Thoughts from a Doc: 
Why do my sugars DO that?!? (Part 2)

Insulin: (as my daughter would say- d’uh!).  Oral pills like glipizide [Glucatrol], glimepiride [Amaryl] or glyburide [Micronase] cause your pancreas to release insulin which can certainly lower glucose values over the course of many hours.  Other medications (repaglinide [Prandin] or nateglinide [Starlix]) act more rapidly and only cause insulin to be released for a few hours.  But the effectiveness of these pills is based on two things: (1) the ability of your pancreas to make and release insulin; and (2) the ability of your body to use the amount of insulin made by the pancreas.  If your pancreas “worn out”, then these medications won’t be very effective (the analogy is that you can’t squeeze anything out of a dry sponge).  Even if these pills help the pancreas to release insulin, if your body is very resistant to insulin, then it won’t be enough.  Resistance to insulin can occur for many reasons including excess weight, infections, and steroid medications such as prednisone, hydrocortisone or dexamethasone. 

Counter-insulin hormones: These can be thought of as “anti-insulin” hormones - fighting against the action of insulin.  The most common of these are steroid medications like prednisone, hydrocortisone or dexamethasone.  These medicines are sometimes used as pills for weeks at a time and can raise blood sugars a lot.  Sometimes, they are injected into joints or other locations and can raise glucose values for a few days.  Other counter-insulin hormones are stress hormones that are released when people are sick with other illnesses.

Next week's post will discuss a few other factors, including the "element of mystery" that anyone with diabetes knows all too well. Not as simple as it seems, sometimes!!