Medications That Can Raise Blood Sugar (Glucose) Levels

You probably expect sugary snacks, enormous bowls of pasta, and skipped workouts to nudge your blood sugar up.
But your medications? That can feel like a plot twist. Yet many commonly used drugsfrom
steroids for a bad rash to statins for cholesterolcan quietly push glucose levels higher than you’d like.

If you live with diabetes or prediabetes, or you’re at higher risk, it’s worth knowing which
medications can raise blood sugar levels, how they do it, and what you can do about it
(spoiler: it’s not “throw all your pills in the trash”). This guide walks through major drug classes linked
with higher glucose and offers practical tips for working with your healthcare team to stay safe.

Why Some Medications Raise Blood Sugar

Blood sugar (glucose) is controlled by a delicate balancing act involving insulin, your liver, your muscles,
your fat cells, hormones, and your daily choices. Many medications can interfere with this balance by:

• Increasing insulin resistance so your cells stop responding as well to insulin.
• Stimulating your liver to release more glucose into the bloodstream.
• Reducing insulin secretion from the pancreas.
• Triggering stress hormones (like adrenaline or cortisol) that naturally raise blood sugar.

The American Diabetes Association notes that medication side effects are a recognized cause of higher
glucose in people with and without diabetes. Illness, stress, and changes in activity often stack on top of
that, making numbers even harder to predict. That’s why any unexplained, persistent jump in blood sugar
deserves a closer look at both your health and your medication list.

Common Medications That Can Raise Blood Sugar

The following are some of the better-known medication groups that can increase blood sugar. This isn’t a
complete list, and not everyone will experience the same effect, but these categories come up repeatedly in
research and clinical practice.

1. Glucocorticoids (Steroids)

Glucocorticoids, often just called “steroids,” are heavy hitters for inflammation. They’re used
for asthma flares, autoimmune conditions, allergies, joint pain, and more. Common examples include:

• Prednisone
• Dexamethasone
• Methylprednisolone
• Hydrocortisone

These drugs can:

• Make your liver pump out more glucose.
• Make your muscles and fat cells more resistant to insulin.
• Interfere with normal insulin secretion from the pancreas.

The result is something called steroid-induced hyperglycemia, which can appear even in people
who’ve never had diabetes before, especially at moderate to high doses taken for days or weeks. Research
shows that glucocorticoid therapy can unmask previously undiagnosed type 2 diabetes or worsen existing
diabetes control.

Steroids taken by mouth or IV have the biggest impact, but high-dose injected or even potent inhaled
steroids can matter too. The good news: for many people, blood sugar trends improve once the steroid dose
is cut back or discontinued under medical supervision.

2. Atypical Antipsychotics

Atypical antipsychotics (also called second-generation antipsychotics) are used to treat
conditions like schizophrenia, bipolar disorder, and sometimes severe depression. Examples include:

• Clozapine
• Olanzapine
• Quetiapine
• Risperidone
• Ziprasidone and others

These medications have been linked to:

• Weight gain and increased visceral fat.
• Higher insulin resistance.
• Impaired insulin secretion.

FDA safety communications and large reviews have found increased risks of hyperglycemia, new-onset
diabetes, and even diabetic ketoacidosis (DKA) in some patients taking these drugs. The risk appears
higher in people who already have risk factors such as obesity or a strong family history of diabetes.

None of that means people should stop antipsychotics on their ownthese medications are essential for
mental health and stability. Instead, it means monitoring fasting glucose or A1C, especially early in
treatment, and working closely with both mental health and primary care providers.

3. Thiazide Diuretics (Certain “Water Pills”)

Thiazide and thiazide-like diuretics are commonly prescribed for high blood pressure and heart
failure. Common examples include:

• Hydrochlorothiazide (HCTZ)
• Chlorthalidone
• Metolazone

These medications help your body get rid of extra fluid and sodium, but they can also slightly increase
blood sugar by affecting how your body handles insulin and electrolytes. Studies and clinical reviews have
found that thiazides can modestly raise fasting glucose and are associated with a small increased risk of
developing type 2 diabetes, especially at higher doses and in people who are already at risk.

In many cases, the cardiovascular benefits of good blood pressure control outweigh this small risk. Still,
your provider may choose the lowest effective dose, combine it with other blood pressure medications, or
monitor your blood sugar more closely.

4. Beta Blockers

Beta blockerssuch as metoprolol, atenolol, and propranololare used for high blood pressure,
heart rhythm problems, heart failure, migraine prevention, and anxiety.

These medications can:

• Mask symptoms of low blood sugar (like shakiness and rapid heartbeat), making hypoglycemia harder to notice.
• In some cases, slightly reduce insulin sensitivity or affect how your body recovers from low blood sugar.

For most people, beta blockers are safe and beneficial, but if you use insulin or medications that can cause
low blood sugar, you and your healthcare team may need a more structured plan for monitoring and managing your
numbers.

5. Statins (Cholesterol-Lowering Medications)

Statinslike atorvastatin, simvastatin, and rosuvastatinare among the most widely prescribed
drugs in the world. They dramatically lower LDL (“bad”) cholesterol and reduce the risk of heart attack and stroke.

Large clinical trials and FDA safety reviews have found a small but real increase in blood sugar and
new-onset diabetes in some people taking statins. The increase is typically modest, often a few points
in fasting glucose or a slight bump in A1C.

For most patients at risk of heart disease, the heart-protective benefits of statins far outweigh this risk.
But if you’re on a statin and already living with diabetes or prediabetes, it’s smart to keep an eye on your
glucose trends and support your medication with lifestyle measuresmovement, balanced eating, and regular
follow-ups.

6. Decongestants and Cold Medicines

That innocent-looking cold tablet may not be so innocent if it contains a decongestant like
pseudoephedrine or phenylephrine. These medications stimulate parts of your nervous system, which can:

• Raise blood pressure and heart rate.
• Trigger stress-hormone pathways that increase blood sugar.

Drug information for pseudoephedrine specifically warns that it may increase blood glucose levels and interfere
with diabetes medications. If you have diabetes, it’s often better to choose sugar-free cough syrups and
non-decongestant products when possible, and ask your pharmacist which options are safer for blood sugar.

7. Niacin (Vitamin B3) and Some Other Cholesterol Medications

Niacin is a B vitamin sometimes used in high doses to improve cholesterol patterns, especially to
raise HDL (“good”) cholesterol. Clinical trials and long-term studies have shown that niacin therapy can
increase fasting blood glucose and A1C, and may raise the risk of developing diabetes in some people.

People who already have diabetes and are prescribed high-dose niacin often need closer glucose monitoring and
possible adjustments in their diabetes medications. In recent years, niacin has been used less often because
newer cholesterol drugs provide benefits without the same glycemic trade-offs.

8. Immunosuppressants (Especially After Transplant)

After organ transplants, people often take long-term immunosuppressant medications to prevent
rejection. One of the most important of these is tacrolimus.

Research has linked tacrolimus to:

• Reduced insulin secretion from the pancreas.
• Increased insulin resistance.
• A condition called post-transplant diabetes mellitus (PTDM).

Not everyone on tacrolimus develops diabetes, but the risk is significant enough that transplant teams closely
monitor blood sugar, especially in the first months after surgery. Adjusting doses, optimizing other medications,
and lifestyle strategies can all help.

9. Hormonal Therapies and Birth Control Pills

Some hormonal therapies, including certain birth control pills and high-dose progestins, can
nudge blood sugars higher in susceptible individuals. Estrogen and progesterone influence insulin sensitivity,
fluid balance, and weightall of which can affect glucose.

For most people, standard-dose hormonal contraception has only a small effect on blood sugar, but if you already
have diabetes, it’s worth letting your prescriber know so they can help choose an option that fits your health
profile and monitoring needs.

10. Other Medications That May Affect Blood Sugar

Other drug classes that may raise blood sugar in some circumstances include:

• Sympathomimetic drugs (certain asthma or ADHD medications) that act like adrenaline.
• High-dose estrogen or steroid injections used in some fertility or cancer treatments.
• Some HIV medications and other immunosuppressants, depending on the specific drug and dose.

The effect varies widely by medication and by individual. Your personal risk depends on your genetics, body weight,
existing insulin sensitivity, and other health conditions.

How to Protect Yourself If You’re at Risk

Learning that common medications can increase blood sugar can feel alarming, but the solution is rarely “stop the
drug.” Instead, think in terms of partnership and planning:

Talk Openly With Your Healthcare Team

• Always tell every provider you see if you have diabetes, prediabetes, or a strong family history.
• Before starting a new medication, ask: “Does this affect blood sugar? How will we monitor it?”
• Never stop steroids, antipsychotics, beta blockers, or other long-term meds suddenly without medical guidance.

Monitor Your Numbers More Closely

• If you have diabetes, check your blood sugar more frequently when starting or increasing one of these drugs.
• Watch for symptoms of high blood sugar: more thirst, frequent urination, fatigue, blurry vision.
• Share home readings with your provider; averages over time matter more than one random high result.

Supportive Lifestyle Adjustments

You can’t “out-walk” a steroid dose, but lifestyle choices still help:

• Focus on high-fiber carbs, lean protein, and healthy fats to blunt glucose spikes.
• Keep movingwalks after meals can help your muscles soak up more glucose.
• Stay hydrated and prioritize sleep; both influence insulin sensitivity.

In some cases, your provider may temporarily adjust your diabetes medications or add another agent while you’re on
a drug that raises glucose (for example, while taking a short steroid course).

Real-Life Experiences With Medications and Blood Sugar

Statistics and mechanisms are great, but they don’t always capture what this looks like in real life. Here are
some common scenarios that people describe when medications and blood sugar collide.

“My Steroid Pack Turned My Glucose Into a Roller Coaster”

Imagine you’re given a short course of prednisone for a nasty asthma flare. You start feeling better almost
immediatelybreathing is easier, the cough calms down, and you sleep without wheezing. Then you check your blood
sugar and see numbers you haven’t seen since the last holiday cookie marathon.

This is classic steroid behavior. Many people report that their glucose:

• Stays higher most of the day, even if they eat “perfectly.”
• Spikes especially in the afternoon and evening, when the steroid dose hits peak effect.
• Gradually settles back down a few days after they finish the taper.

Providers sometimes pre-plan for this by recommending more frequent checks, temporary medication adjustments, or
very targeted insulin use while the steroid is on board. The key is knowing it’s expectednot a personal failure
and having a strategy ready.

“The Cold Medicine That Quietly Raised My Numbers”

Another common story: someone with usually well-controlled type 2 diabetes comes down with a brutal cold. They
can’t breathe through their nose, so they grab an over-the-counter cold and flu remedy with a decongestant. Within
a couple of days, they notice their glucose numbers creeping up.

It’s easy to blame the illness alone (and to be fair, infections do raise blood sugar), but decongestants
like pseudoephedrine can add fuel to the fire by stimulating stress pathways that increase glucose. People often
say things like:

• “My numbers weren’t crazy high, but they were consistently 20–40 mg/dL above my usual.”
• “They dropped back closer to baseline once I stopped the cold pills.”

Pharmacists can be invaluable here, helping you choose cold remedies that won’t clash as much with your glucose
managementoften favoring saline sprays, non-decongestant options, or short-term, carefully monitored use.

“I Started a Statin and My A1C Nudged Up”

Many people starting a statin are surprised when their next A1C is slightly higher. It’s typically not a dramatic
leap, but it’s noticeableperhaps from 6.4% to 6.7%, or from 7.1% to 7.4%. Understandably, this can feel frustrating
when you’ve otherwise kept your lifestyle steady.

Clinicians will often frame this conversation around trade-offs: a small increase in blood sugar versus a large,
well-documented reduction in heart attack and stroke risk. Often, the plan is:

• Keep the statin, because the heart benefits are substantial.
• Double down on lifestyle supportnutrition, activity, weight management.
• Consider a modest adjustment in diabetes therapy if needed.

Patients who know to expect this possibility often feel less blindsided and more empowered to fine-tune their
overall plan.

“After My Transplant, Blood Sugar Became One More Vital Sign”

For people who receive kidney, liver, or other organ transplants, the primary goal is keeping that new organ
healthy. Medications like tacrolimus are life-saving, but they come with the potential side effect of
post-transplant diabetes mellitus.

Many transplant recipients describe the early months after surgery as a constant balancing act:

• Monitoring drug levels to prevent rejection.
• Watching for infection.
• Checking blood sugar regularly, as tacrolimus doses are adjusted.

The encouraging part is that transplant teams are typically very experienced with these issues. They may involve
endocrinologists early, use continuous glucose monitors, and adjust the immunosuppressive regimen if blood sugar
becomes a significant problem. For some patients, elevated glucose is temporary and improves as doses are lowered.

“What Patients Say Helps the Most”

Across these different stories, a few themes show up again and again:

• Information reduces anxiety. Knowing that a medication can raise blood sugar helps you respond instead of panic.
• Data beats guesswork. Glucose logs, CGM downloads, and patterns over time are more helpful than one scary number.
• Teamwork matters. People feel safer when their prescriber, pharmacist, and diabetes care team are on the same page.
• Medication isn’t “good” or “bad.” The same steroid that raises glucose might prevent a hospitalization for asthma; the statin that nudges A1C up might prevent a heart attack.

The goal isn’t perfection; it’s informed balancing. With open communication and good monitoring, many
people successfully take these medications while keeping their blood sugar in a safe range.

Bottom Line

Plenty of medications can raise blood sugar, including steroids, atypical antipsychotics,
thiazide diuretics, beta blockers, statins, decongestants, niacin, immunosuppressants like tacrolimus, and some
hormonal therapies. For most people, these drugs have important benefits, and the answer is not to avoid them
entirely but to use them with eyes wide open.

If you notice rising numbers after starting a new medicationor if you already live with diabetes and are about to
begin one of these drugstalk to your healthcare provider. Together, you can build a plan that respects both sides
of the equation: the condition the drug is treating and your long-term metabolic health.

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