Lupus and Your Blood Sugar

Lupus is an autoimmune disease that can affect different parts of the body. Lupus causes your own immune system to attack healthy tissue in your skin, heart, lungs, kidneys, brain, or other organs. Lupus can also disturb normal blood sugar levels.^1,2

How does lupus affect blood sugar levels?

Your body needs to control the amount of sugar in the blood to function properly. To do this, the pancreas releases a hormone called insulin. Insulin helps sugar from the blood enter cells, which use it to create energy.³

If your body produces too much or too little insulin, abnormal blood sugar levels may result. Sometimes cells stop responding to insulin, which can also cause high amounts of sugar in the blood. Lupus can change how much insulin you produce or how your body reacts to insulin. This can lead to changes in your blood sugar levels.^2,4

Lupus and hypoglycemia

Hypoglycemia means the amount of glucose (or sugar) in the blood is much lower than normal. For many people, this happens when blood sugar is lower than 70 milligrams per deciliter (mg/dL). People who have type 1 diabetes or who take insulin as a treatment are most likely to have low blood sugar.⁵

There is also a relationship between lupus and hypoglycemia. Some medicines used to treat lupus can cause hypoglycemia. For example, hydroxychloroquine is a drug that can reduce the symptoms of lupus. But some people experience low blood sugar levels when they take this drug.⁶

Lupus and hyperglycemia

Hyperglycemia means blood sugar levels are higher than normal. Blood sugar levels can change throughout the day, especially after eating. But blood sugar levels that are greater than 125 mg/dL while fasting indicate hyperglycemia. Consistently having high blood sugar can lead to type 2 diabetes.⁷

People living with lupus are at a higher risk for type 2 diabetes. In fact, 1 study found that people with lupus were 22 percent more likely to get type 2 diabetes. This may be because of the damage lupus causes to the body. Drugs used to treat lupus may also cause high blood sugar, leading to type 2 diabetes.^2,4

If lupus has damaged the pancreas, then the pancreas will produce less insulin. Less insulin means there will not be enough insulin available to help the sugar from the blood enter the cells. As a result, blood sugar levels will rise.^2,4

Another cause of hyperglycemia is insulin resistance. In this case, the pancreas keeps producing insulin, but the body becomes less sensitive to the insulin. Lupus or the drugs used to treat it can cause insulin resistance.^2,4

For example, steroids may be used to treat lupus. But steroids can increase the chances of developing insulin resistance. Having insulin resistance can then lead to type 2 diabetes.^2,4

How to deal with changing blood sugar

There is a link between lupus and abnormal blood sugar levels. Talk with your doctor if you are concerned about your blood sugar. Here are few things that might be helpful:^2,6,8

• Track your blood sugar. Lupus can cause both high and low blood sugar. Track your blood sugar to learn whether your blood sugar is higher or lower than normal. Then, you and your healthcare provider can come up with a plan to get your blood sugar levels back to normal.
• Know the possible side effects of the drugs you are taking. Steroids are used to treat lupus, but they can also cause high blood sugar. Hydroxychloroquine can cause low blood sugar, but it also reduces the chances of developing diabetes. Talk through the possible effects of your drugs with your doctor.
• Prevent diabetes. A healthy diet and regular physical activity can lower your chances of getting diabetes. Ask your healthcare provider about other ways to prevent diabetes.