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Nutrition and daily life

Leukemia and diabetes: managing blood sugar

Diabetes can complicate leukemia treatment: steroids and some medicines raise blood sugar, and infections make it unstable. At the same time, eating enough matters. This section explains how to balance the two needs.

Last updated: ~1 min read
A meter and a balanced plate.
Figure 1.Sugar and plate — Leukemia and diabetes: managing blood sugar

01Short answer

During a steroid course blood sugar can rise sharply, so check it as often as your team says. Eat at regular times, spread carbohydrates through the day and swap sweet drinks for water. Choose whole grains, legumes, vegetables and protein. If you have no appetite and are losing weight, strict limits are not needed; change targets with your team. Do not change insulin or tablet doses yourself. Tell your team at once about great thirst, passing a lot of urine, confusion, shaking or sweating.

02Simple explanation

Steroids raise sugar.

Regular meals.

No sweet drinks.

Do not change doses yourself.

03Scientific explanation

ADA: nutrition in diabetes should be individual; carbohydrate quality and amount and regular meals help control blood sugar.

ESPEN: enough energy and protein matter for preventing weight and muscle loss in people with cancer, and nutritional status should be assessed regularly.

NCI: practical eating tips exist for treatment side effects such as nausea, taste changes and mouth sores.

04What happens in the body?

Hypoglycaemia

If you cannot eat, insulin can drop sugar too low; always carry fast-acting sugar.

Whole grains and legumes
Figure 2.Whole grains and legumes.

Endocrinologist

During treatment, plan together with an endocrinologist and a dietitian.

A blank calendar and a small plate.
Figure 3.Steroid days — Leukemia and diabetes: managing blood sugar

Dietitian

If you are losing weight, have no appetite or need a special diet, ask to see the hospital dietitian.

Food safety

Food-safety rules for neutropenia (see “Handwashing: the simplest protection” and “Eggs and dairy: safe choices”) apply at every stage.

05Nutrition: four steps

Assess, swap the risky, cook safely, eat regularly.

Assess — Weight and appetite.1AssessWeight and appetite.
Swap — A safe choice.2SwapA safe choice.
Cook — Hot throughout.3CookHot throughout.
Eat regularly — Small portions.4Eat regularlySmall portions.
StrengthEnergy.
ProteinFor muscle.
SafetyFood rules.

06Key points at a glance

TopicIn brief
HypoglycaemiaIf you cannot eat, insulin can drop sugar too low; always carry fast-acting sugar.
EndocrinologistDuring treatment, plan together with an endocrinologist and a dietitian.
DietitianIf you are losing weight, have no appetite or need a special diet, ask to see the hospital dietitian.
Food safetyFood-safety rules for neutropenia (see “Handwashing: the simplest protection” and “Eggs and dairy: safe choices”) apply at every stage.

07Key terms

Hypoglycaemia
Blood sugar that is too low.
Steroid-induced diabetes
High sugar caused by steroids.
Dietitian
A nutrition specialist.
Protein
A nutrient for repairing muscles and tissues.
Neutropenia
Low neutrophils.

08Key points

  • Measure.
  • Eat regularly.
  • The team changes doses.
  • A diet is not a treatment.
  • Talk to a dietitian.

09Frequently asked questions

Are sweets completely banned?

No; a little after a meal is fine.

Will sugar fall after steroids?

Usually yes; doses may need lowering.

Can a special diet cure leukemia?

No. Good nutrition helps you cope with treatment, but it does not cure.

10Questions for your doctor

Take these questions to your appointment. The ones you save are collected on the “My questions” page and stay on this device only.

  1. Are sweets completely banned?

  2. Will sugar fall after steroids?

  3. Can a special diet cure leukemia?

My questions

12Sources

  1. American Diabetes Association. Food & Nutrition
  2. National Cancer Institute. Eating Hints: Before, During, and After Cancer Treatment
  3. ESPEN. ESPEN practical guideline: Clinical Nutrition in cancer (2021)
  4. Leukemia & Lymphoma Society. Food and Nutrition
  5. World Health Organization. Healthy diet fact sheet
  6. NIH Office of Dietary Supplements. Dietary Supplement Fact Sheets
  7. NHS. The Eatwell Guide
  8. FoodSafety.gov (U.S. HHS). Egg safety
  9. CDC. Salmonella and Eggs
  10. NHS. Milk and dairy in your diet
Medical disclaimerThis information is for educational purposes only and does not replace medical advice.
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