A long time patient of mine made an appointment with me just to ask some questions about his topical corticosteroid therapy. He had read the package insert, and had become concerned. The side effects stated that the medication could potentially make his diabetes worse. His “sugars” were higher after applying the medication for a couple of weeks.
I have to admit, I was dismissive at first. But when I researched my patient’s question, I found that that he was correct. I also discovered that potent topical corticosteroids can cause significant pituitary gland suppression. 20% of patients using these drugs for more than 3 weeks suppress the release of cortisol from their adrenal gland. The dose can be as low as 2 grams per day.
So sometimes, I find I need to rediscover things that I used to know. Thanks to this patient’s perceptive question, I can help others avoid side effects from these frequently prescribed medications.