Blood sugar is the amount of sugar (glucose) in the blood. Some medications can cause blood sugar to fluctuate, either up or down. What drugs raise blood sugar? What precautions for use and contraindications?
What is the list of drugs that raise blood sugar?
Blood sugar is the amount of sugar (glucose) in the blood.. It can be measured with a blood test or by fingertip capillary action using a blood glucose meter. Blood glucose levels are linked to two hormones produced by the pancreas: insulin and glucagon. These hormones are responsible for balancing blood sugar throughout the day based on meals, physical activity and rest periods. Normal blood sugar values are 0.7 to 1.1 g/L. In the event of severe hypoglycaemia, it is possible to use glucagon in order to increase the level of glucose in the blood, by mobilizing the stores of glycogen present in the liver. Existing drugs based on glucagon are Baqsimi® (powder for nasal inhalation) and the Glucagen® (solution for injection). In addition, many drugs, taken alone or in combination, are likely to cause blood sugar levels to vary, either up or down. These drugs are thus likely to cause hyperglycaemia, trigger or unbalance diabetes. These include:
- of the gabapentin (treatment of epilepsy),
- of the somatostatin and its derivatives (hormonal treatment),
- of olanzapine, clozapine and other neuroleptics,
- from salbutamol and terbutaline (treatments of asthma and respiratory diseases),
- of the statins : simvastatin, atorvastatin, fluvastatin, pravastatin and rosuvastatin (cholesterol treatments),
- of the thiazide diuretics : hydrochlorothiazide, indapamide and cicletanine or high dose handle : furosemide, bumetanide and piretanide (treatments of hypertension),
- summeracrolimus and ciclosporin and other anti-transplant rejection treatments,
- of the corticosteroids (anti-inflammatories),
- from diazoxide and glucagon (treatments of hypoglycaemia),
- of the protease inhibitors : ritonavir, darunavir, atazanavir, lopinavir, saquinavir, indinavir, tipranavir and fosamprenavir and reverse transcriptase inhibitors: emtricitabine, lamivudine, zidovudine, abacavir and tenofovir (treatments for AIDS)
- of the estrogen-progestins (oral contraceptives).
Finally, all medicines containing sugar or alcohol, and in particular syrups, can raise blood sugar. These drugs are numerous, so it is important to take into account the presence of sugar in a drug in case of diabetes or in case of need for prolonged intake of the drug.
Are they over-the-counter or prescription?
All drugs marketed to raise blood sugar or which have a possible blood sugar increase as a side effect are medical prescription required and therefore cannot be obtained without a prescription. However, this is not always the case for drugs containing sugar or alcohol, such as certain syrups, which can be on sale and thus be purchased without a prescription.
What are the precautions for use?
Glucagon should be taken in case of severe hypoglycaemia in people at risk (usually people with diabetes treated with hypoglycemic drugs). It’s important to know how to recognize the symptoms hypoglycemia in order to take it at the right time and in the right way. Members of the family or entourage must also be informed and trained in the use of glucagon, if necessary. After taking glucagon administered in the case of severe hypoglycemia, it is necessary to administer oral carbohydrates to replenish hepatic glycogen stores. This will prevent recurrences of hypoglycaemia. In addition, glucagon is not effective in patients whose hepatic glycogen stores are already depleted. For this reason, glucagon not recommended for prolonged fasting, low adrenaline, chronic hypoglycemia, or alcohol-induced hypoglycemia. Taking certain medications can also alter the action of glucagon or alter their own action, such asinsulin, indomethacin, warfarin and beta-blockers. When taking a drug that has the undesirable effect of raising blood sugar, it is important to tell the doctor if diabetes is known (whether or not treated with medication) or if there are risk factors for diabetes (family history, smoking, high blood pressure, high cholesterol, lack of physical exercise, overweight or obesity, etc.). If a blood sugar-raising drug is already in place and an existing diabetes is balanced, then no special precautions are necessary as long as the treatment is continued in the same way. However, in case of discontinuation of the drug, the blood sugar could consequently decrease and disrupt the existing diabetes, or even cause hypoglycaemia. It will therefore be important to watch for any signs of hypoglycaemia:
- a pallor
- a feeling of hunger
- blurred vision
- a feeling of weakness
- or a loss of balance
Conversely, if diabetes exists and is balanced (or is likely to be triggered due to the presence of risk factors), the initiation of a drug that increases blood sugar could be problematic (imbalance or triggering of a diabetes, hyperglycaemia). In this case, it will be necessary to pay attention to the symptoms of high blood sugar:
- copious urine
- intense thirst
- exaggerated hunger
- weight loss
In all cases, when starting or stopping these medications, it may be necessary to adjust the dosages or modify the current antidiabetic treatment. Supervision by a doctor is therefore very important. Furthermore, when a syrup or medicine containing sugar or alcohol is prescribed, it is strongly advised to prefer sugar-free or alcohol-free forms when they exist, in case of diabetes existing or at risk of diabetes if risk factors are present. In addition, it is not recommended for people with diabetes to resort to self-medication as this could unbalance their diabetes. It is also necessary to inform and question health professionals in the event of biological analyzes that are outside normal values, or in case of recurring symptoms while taking medication. Finally, it may be useful to check your blood sugar regularly or more frequently when taking a drug likely to increase it.
What are the side effects of these drugs?
Adverse effects of glucagon (Glucagen®, Baqsimi®) are rare and can be:
- a reaction allergic (generalized rash, swelling of the face, anaphylactic shock with difficulty in breathing and hypotension)
- of the nausea
- of the vomiting
- of the abdominal pain
- of the headache
- a increased blood pressure and heart rate (transient effect)
The inhaled form (Baqsimi®) can also cause tearing (red eye, irritations) and irritate the upper respiratory tract. Medications that raise blood sugar as a side effect are many and varied. Apart from the risks of hyperglycemia they present, they also have their own adverse effects, which are directly related to their mechanism of action.
What are the contraindications for drugs that increase blood sugar?
Glucagon-based drugs intended to raise blood sugar in severe hypoglycemia are contraindicated in case of hypersensitivity to glucagon or to a substance contained in the medicinal product as well as in the event of adrenal gland tumor (pheochromocytoma). The inhaled form is contraindicated before 4 years. Medications that raise blood sugar through their side effects are many and varied. In addition to their own contraindications related to their mode of action in the body, they may be contraindicated or inadvisable in case of existing diabetes or onset of diabetes. They should also not be stopped without medical advice.
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