Living Well Sometimes, in medical research, a specific disease or drug makes the rounds in research headlines. It might not be something you see every day, but suddenly everyone wants to talk about it.
Today, it's a class of drugs called glucocorticoids.
That's a bit of a tongue twister, but you're likely to recognize some of the drugs in this class: think prednisone, cortisone, and hydrocortisone.
Glucocorticoids are produced naturally in our bodies. They are hormones that regulate several processes in our bodies – everything from boosting our energy when we wake up, to lowering inflammation and calming down our immune system.
Lab-made or synthetic glucocorticoids treat a range of problems from allergic reactions to heart failure to autoimmune diseases like eczema and multiple sclerosis. We have receptors for the hormone throughout our bodies, so it affects us in many different ways.
What caught our eye was a new study on diabetes that looked at these drugs. So, if you receive one of the 10 million prescriptions written in the U.S. every year, you need to read this...
This study, from the University of Oxford and Sapienza University of Rome, isn't even published yet. But a presentation of the study at the annual conference of the Society for Endocrinology showed glucocorticoids likely increase your risk of Type 2 diabetes. It turns out that the natural form of glucocorticoids we produce regulates our blood sugar.
Another study this year out of Germany tracked the 24-hour cycle of the hormones in mice to see how glucocorticoids work. Researchers found the glucocorticoids peak just before you wake up. The idea is that they signal your body to use up fatty acids and sugar to produce that energy. So, they have to signal your liver to release fat from its storage and our blood sugar to rise.
But hold on... if you mess with your circadian rhythm (e.g., by getting poor quality sleep, sleeping during the day, or staying up too late) you can mess with these glucocorticoids. You'll store too much fat and struggle with blood sugar problems.
Here's the other thing... There are different kinds of glucocorticoids. The one we use the most in our bodies is cortisol.
If that term sounds familiar, it's because I've written extensively about cortisol. It's this hormone that gives us a boost, but it's also a stress hormone. Too much stress and it goes into overdrive – your body can't shut down from the "fight or flight" response that cortisol demands. As a result, we wind up with things like high blood pressure, reduced immunity, and weight gain.
Here's the thing. Too much cortisol over sustained periods leads to high blood sugar levels – your body is constantly trying to break down glucose, so that you'll have the energy to fight your stressor or flee from it.
This new study from Oxford and Sapienza, however, shows that these drugs that mimic our natural hormones might also contribute to diabetes.
They tested their theory on a very small group of healthy human volunteers. Each took the standard dose of the drug Prednisone over a one-week period.
The complication was this: Their blood sugar didn't spike. So, you might think they were fine. But the researchers looked at a variety of blood markers and they found that after just one week, the volunteers had a reduced ability to regulate their blood sugar.
Imagine seeing those findings after just a week. Now consider that some folks take these drugs for years.
I've often said that diabetes is a condition with roots in chronic inflammation. And for an anti-inflammatory to have these effects seems a bit counterintuitive. But it's important to know that these drugs interfere with the breakdown of glucose. That's alone is a huge issue. Plus, the other side effects – like weight gain – also raise your risk of diabetes.
So, if your doc prescribes any anti-inflammatory, ask if it's a glucocorticoid. If so, ask about how long you'll be on it and what you can do to monitor for this risk. Often, it comes down to a risk-benefit analysis based on what you're trying to treat and your other risk factors for diabetes.
This study also serves as a good reminder this season as we stay inside more often... to put down your phone. Blue light from screens like the one on your cellphone artificially trigger the release of cortisol. Make a conscious effort to move more – even if that means doing jumping jacks or walking in place inside because it's too cold to go out. Exercise also helps lower cortisol levels.
As I've said, I've written a lot about these topics before. If you want to learn more about diabetes and stress, check out a few of my essays here and here. And if there's anything you'd like me to cover, feel free to send me a message, here.
What We're Reading...
- A more in-depth look at this study.
- Something different: Is it possible that we could live to see 200?
Here's to our health, wealth, and a great retirement,
Dr. David Eifrig and the Health & Wealth Bulletin Research Team
November 19, 2019