Does Budecort Increase Blood Sugar? Separating Inhaled from Oral Risks

October 7, 2025 •

3 min read

Over 30 million people in the United States have diabetes, and many rely on corticosteroid medications like Budecort (budesonide) to manage other conditions. The question, 'Does Budecort increase blood sugar?', is crucial for those balancing these health concerns, as the answer depends on several factors, most significantly the medication's form and dose.

Quick Summary

Budesonide, the active ingredient in Budecort, has the potential to raise blood sugar levels, though the risk varies greatly depending on whether it is an inhaled or oral formulation. Systemic administration carries a higher risk of hyperglycemia and can exacerbate diabetes, while inhaled versions pose a lower risk, but caution is still advised for those with pre-existing diabetes. Management involves careful monitoring and medical consultation.

Key Points

Dose and Form Matters: The likelihood of Budecort (budesonide) increasing blood sugar depends heavily on whether it is an inhaled or oral medication, with oral forms posing a higher risk.
Inhaled Form is Lower Risk: Inhaled Budecort has a lower systemic absorption, leading to a much lower risk of elevating blood sugar levels compared to oral forms.
Risk for Diabetics: Even with inhaled Budecort, individuals with pre-existing diabetes should be aware of a dose-dependent increase in glucose levels and monitor their blood sugar closely.
Oral Form is Higher Risk: Oral budesonide has a known risk of causing hyperglycemia, especially with higher doses or long-term use, and requires careful monitoring.
Management is Key: For patients with diabetes, close communication with a healthcare provider and increased blood sugar monitoring are crucial to manage the potential side effect of hyperglycemia.
Hyperglycemia Symptoms: Watch for symptoms of high blood sugar, such as increased thirst, frequent urination, or blurred vision, and report them to your doctor.

What is Budecort and How Does it Affect Blood Sugar?

Budecort is a brand name for the medication budesonide, a type of glucocorticoid, or steroid. It is primarily used to reduce inflammation and is available in various forms, most commonly as an inhaled powder or suspension for respiratory conditions like asthma and COPD, and as an oral tablet for gastrointestinal issues like Crohn's disease.

Glucocorticoids are known to interfere with glucose metabolism by several mechanisms, which is why systemic versions carry a higher risk for elevated blood sugar levels. The primary mechanisms include:

Increasing hepatic gluconeogenesis: Stimulating the liver to produce more glucose.
Inducing insulin resistance: Making the body's cells less responsive to insulin, which is needed to transport glucose from the blood into cells for energy.
Decreasing glucose utilization: Reducing the amount of glucose that peripheral tissues use.

The Difference Between Inhaled and Oral Budesonide

The primary reason for the difference in blood sugar impact is the degree of systemic absorption. Budesonide is designed to have a high "first-pass metabolism" when taken orally, meaning the liver breaks down a significant amount of the drug before it can circulate throughout the body. This minimizes systemic side effects. However, in some cases, or for certain conditions, this metabolism is altered, or the dose is high enough to still cause systemic effects.

Inhaled Budecort and Blood Sugar

Inhaled Budecort, delivered directly to the lungs, is considered a local treatment, resulting in minimal absorption into the bloodstream. For this reason, the risk of significant blood sugar elevation is generally considered very low for people without diabetes.

However, this does not mean the risk is zero, especially for individuals with diabetes. A study among veterans, for example, showed a dose-dependent increase in serum glucose for those with diabetes using inhaled corticosteroids. Higher doses and prolonged use are the main factors that can increase this minimal risk. Therefore, even with inhaled forms, regular monitoring is prudent for diabetic patients.

Oral Budesonide and Blood Sugar

Oral budesonide (e.g., extended-release tablets) is a systemic medication, and as a result, it carries a more substantial risk of increasing blood sugar levels. This can lead to hyperglycemia, especially in patients with pre-existing diabetes or pre-diabetes. In rare cases, high systemic levels can cause severe hyperglycemia or even trigger steroid-induced diabetes. For example, one case study detailed a patient who developed a hyperosmolar hyperglycemic state after a procedure (TIPS) altered their budesonide metabolism.

Risk Comparison of Budesonide Forms


Feature	Inhaled Budesonide (e.g., Budecort Respules)	Oral Budesonide (Tablets)
Mechanism	Localized to the lungs, with minimal systemic absorption.	Designed for high first-pass metabolism, but still has systemic effects.
Risk of Hyperglycemia	Generally low risk for most users.	Higher risk, especially with higher doses or long-term use.
Diabetic Patients	Increased glucose concentration noted in a dose-dependent manner for those with diabetes.	Significantly increased risk of hyperglycemia and potential need for medication adjustment.
Potential Side Effects	Hyperglycemia is a less common side effect.	Hyperglycemia is a more common side effect, potentially leading to increased thirst or urination.

Managing Blood Sugar While on Budecort

For patients taking any form of budesonide, particularly those with diabetes, proactive management is key. This involves collaboration with your healthcare provider to create an effective plan.

Monitoring and Adjustment

Regular Blood Sugar Monitoring: If you have diabetes, check your blood sugar levels more frequently when starting or changing the dose of budesonide.
Discuss with Your Doctor: Communicate any significant or unexplained changes in your blood glucose readings with your healthcare team.
Medication Adjustments: Your doctor may need to adjust your diabetes medication (e.g., insulin or oral hypoglycemics) to counteract the effect of the steroid.

Lifestyle Strategies

Healthy Diet: A balanced, low-glycemic diet can help minimize blood sugar spikes.
Consistent Exercise: Physical activity improves insulin sensitivity and helps manage blood sugar levels.

Conclusion

While Budecort (budesonide) can increase blood sugar, the risk is not equal across all forms. Inhaled Budecort has a generally low risk for hyperglycemia, although patients with diabetes should remain vigilant and monitor their levels, particularly at higher doses. In contrast, oral budesonide carries a more significant and well-documented risk due to its systemic absorption. Open communication with a healthcare provider is essential for any patient with diabetes using budesonide, ensuring effective management of both their primary condition and their glucose levels. For more information on budesonide and its side effects, consult a reliable medical resource such as the Memorial Sloan Kettering Cancer Center website.

Frequently Asked Questions

Yes, a Budecort inhaler can potentially cause high blood sugar, but the risk is generally considered low because the medication is absorbed minimally into the bloodstream. However, a study showed a dose-dependent increase in glucose in patients with diabetes using inhaled corticosteroids, so monitoring is advised, especially at higher doses or for people with pre-existing diabetes.

Yes, oral budesonide affects blood sugar more significantly than the inhaled version. Oral forms are considered systemic treatments and carry a higher risk of elevating blood glucose levels, particularly in individuals with diabetes.

Diabetics prescribed Budecort should monitor their blood sugar levels closely, especially when starting or changing the dose. It is crucial to discuss any changes in blood glucose readings with your healthcare provider, who may need to adjust your diabetes medication to maintain control.

Corticosteroids can increase blood sugar by stimulating the liver to produce more glucose (gluconeogenesis) and by causing the body's cells to become less sensitive to insulin, a condition known as insulin resistance.

Signs of high blood sugar (hyperglycemia) from a steroid can include increased thirst, more frequent urination, unusual fatigue or weakness, and blurred vision. You should report these symptoms to your care team as soon as possible.

Blood sugar elevation from steroids is often reversible after stopping or reducing the medication. However, close monitoring and medical management are essential during and after treatment. Some cases have been severe and required hospitalization.

You can minimize the risk by taking the medication exactly as prescribed, monitoring your blood sugar regularly (especially if you have diabetes), maintaining a healthy diet and exercise routine, and communicating any concerns or changes to your healthcare provider.