Methotrexate and High Blood Sugar Readings
High Blood Sugar Readings and Diabetes
While the occasional high blood sugar value is expected in those with diabetes, prolonged high blood sugars can lead to diabetic complications such as kidney disease, neuropathy and blindness. Severe high blood sugars can also lead to hospitalization for dehydration or a pH imbalance in the blood that can lead to diabetic ketoacidosis, or DKA. When taking new medications like methotrexate, people with diabetes need to be conscious of their blood sugar levels throughout the day and night to ensure that they do not rise too high. It is also important for doctors to monitor patients on immunosuppressant drugs like methotrexate to ensure that blood sugar levels remain normal.
Medicating Autoimmune Diseases
Type 1 diabetes is an autoimmune disorder that results when the body’s immune system attacks the insulin-producing beta cells in the pancreas. The result is that the pancreas stops producing the necessary quantity of insulin after meals and throughout the day and night. Bolus and basal insulin must be used to compensate. Those with one autoimmune disorder may suffer from other autoimmune disorders such as rheumatoid arthritis and psoriasis. For some of these disorders, immune-suppressing drugs are used to moderate the symptoms of the disease.
Methotrexate is an Immunosuppressant
Methotrexate is an anti-inflammatory and immunosuppressant drug that is used to treat cancers such as leukemia. It is also used in small quantities to treat immune disorders such as rheumatoid arthritis and psoriasis. The goal of this therapy is to treat the immune system that is causing pain and damage to the body. Methotrexate is usually given by injection or through tablets. This drug has many drug interactions and can be toxic if taken improperly, so it must be used under a doctor’s supervision.
Methotrexate and High Blood Sugar Readings
In those who do not have diabetes, the use of methotrexate can precipitate type 2 diabetes. One of the main symptoms of diabetes is a high blood sugar reading upon waking or a high A1C or average blood sugar value.
Methotrexate and high blood sugar readings are also linked through drug interactions, since drugs used to treat type 2 diabetes may interact with methotrexate, causing changes in blood sugar values. Drugs with known interactions with methotrexate include acetohexamide (Dymelor), chlorpropamide (Diabinese), glipizide (Glucotrol), glimepiride (Amaryl) and tolbutamide (Orinase). Patients with pre-existing diabetes should monitor their blood sugar values to ensure that they do not go too low or too high on methotrexate. Patients taking methotrexate should be closely monitored to ensure that they continue to have a healthy liver and normal blood sugar values.
Methotrexate and Liver Damage
In a normal person, the liver slowly releases glucose into the body over the course of the day and night. This helps keep blood glucose levels stable. Over time, methotrexate can damage the liver. It is important to monitor liver functioning to ensure that liver damage and changes in blood sugar values do not occur.
References
MIMS USA: Methotraxate
https://www.mims.com/USA/drug/info/methotrexate
UNC School of Medicine. What is Methotrexate?
https://www.med.unc.edu/gi/ibd/images/treatment-of-crohns/Methotrexate.pdf
The US National Library of Medicine. Methotrexate.
https://www.nlm.nih.gov/medlineplus/druginfo/meds/a682019.html
