Steroid-induced diabetes / hyperglycaemia 

What is steroid-induced diabetes / hyperglycaemia? 

Steroid-induced diabetes 

Hyperglycaemia caused by steroid therapy in patients without a previous diagnosis of diabetes.

Steroid-induced hyperglycaemia 

Worsening glucose control following the use of steroids in patients with diabetes. 

How often should CBG be tested if steroids are in use? 

• Once daily if no previous diagnosis of diabetes (before lunch / evening meal). If CBG >12mmol/L then increase monitoring frequency to four times a day.   
• Four times a day in patients with known diabetes. 

When should I treat hyperglycaemia in patients on steroids? 

• No previous diagnosis of diabetes:  If CBG >12mmol/L on 2 or more occasions in 24 hours, see management of steroid-induced diabetes.
• Known diabetes: if CBG >12mmol/L on 2 or more occasions in 24 hours see management of steroid-induced hyperglycaemia. 
• If CBG ≥18mmol/L on 2 or more occasions in 24 hours start VRIII and refer to Variable Rate Intravenous Insulin Infusion (VRIII) guidance. 

Guideline reviewed: February 2025

Page updated: November 2025