Blood Sugar Changes
Steroids (dexamethasone, prednisone) routinely used in cancer treatment cause significant hyperglycaemia, especially post-meal. Some targeted therapies (mTOR inhibitors: everolimus, temsirolimus) cause diabetes-like hyperglycaemia. Hormonal therapies cause insulin resistance. Blood sugar management reduces fatigue, infection risk, and poor wound healing.
Herbs & Supplements — Safety Information
Herbal information is for educational purposes. Many herbs interact with chemotherapy and other medications — consult your oncologist before use.
When to Seek Medical Help Immediately
- •Blood glucose above 13 mmol/L (234 mg/dL) repeatedly
- •Symptoms of diabetic ketoacidosis: fruity breath, nausea, confusion, rapid breathing
- •Very low blood glucose (below 4 mmol/L) with sweating, tremor, confusion
3 Natural Remedies
Low Glycaemic Index Diet
Best for: Steroid-induced hyperglycaemia, mTOR inhibitor diabetes, hormonal therapy insulin resistance
A low-GI diet reduces the post-meal blood glucose spike that is particularly severe with steroid-induced hyperglycaemia. The effect of steroids on blood glucose is greatest 4–8 hours after the morning dose, peaking around lunchtime and afternoon. Dietary modification timed to this pattern significantly reduces peak glucose levels.
🧪 How to Prepare
Replace: white rice → basmati or cauliflower rice; white bread → whole grain, seeded, or sourdough; regular pasta → legume-based pasta or al-dente portions. Increase: non-starchy vegetables, legumes, nuts. Avoid: sugary drinks, fruit juice, sweets, white refined carbohydrates. At every meal: pair carbohydrates with protein, fat, and fibre — this significantly blunts glucose rise.
⏰ When to Take
All day, every day during steroid treatment. Greatest impact from the meals eaten 4–8 hours after morning steroid dose.
Berberine
Best for: Steroid-induced hyperglycaemia (after oncologist approval), pre-existing type 2 diabetes during treatment
Berberine is an alkaloid found in goldenseal, barberry, and Oregon grape. Multiple meta-analyses show it lowers fasting and post-meal blood glucose comparably to metformin through AMPK activation and gut microbiome modulation. It is now widely studied as an adjunct for steroid-induced hyperglycaemia in cancer patients.
🧪 How to Prepare
Berberine HCl 500 mg, 2–3 times daily, taken with or just before meals. Start at 500 mg once daily and increase over 2 weeks to reduce GI side effects.
⏰ When to Take
With or immediately before meals. Dividing doses throughout the day is more effective than a single large dose.
Blood Glucose Monitoring
Best for: All patients on regular dexamethasone, mTOR inhibitors, or existing diabetes
Self-monitoring of blood glucose (SMBG) during steroid treatment identifies patterns that inform dietary and medical management. Steroid hyperglycaemia is often initially undiagnosed because fasting glucose (tested at standard blood draws) may be normal while post-meal levels are severely elevated. Continuous glucose monitors (CGMs) or fingerstick monitoring reveals the true pattern.
🧪 How to Prepare
Request glucose monitoring strips and meter from oncology team or GP. Test fasting (on waking), 2 hours after breakfast, and 2 hours after lunch (this is when steroid peak effect occurs). Log results. Target: fasting <7 mmol/L, post-meal <10 mmol/L. Share logs with oncology team.
⏰ When to Take
Throughout steroid-containing treatment cycles, especially high-dose dexamethasone.
Evidence Level Guide