Do Anabolic Steroids Affect Blood Sugar and Insulin?

Roids Questions Team

One of the most common questions our team gets from readers sounds simple: do anabolic steroids mess with your blood sugar? The short answer is yes, they can — but the long answer is more interesting, because a huge chunk of what you’ll find online about “steroids and blood sugar” isn’t actually about anabolic steroids at all. We went through the available research and practical data to lay out what’s really known: how these compounds may affect insulin sensitivity and glucose metabolism, whether they can push someone towards diabetes, how growth hormone fits into the picture, and — most importantly — which markers you should be tracking and how often.

What’s the difference between anabolic steroids and corticosteroids when it comes to blood sugar?

Before anything else, we need to clear up a confusion that derails most discussions of this topic. The word “steroids” covers two different drug classes:

Anabolic-androgenic steroids (AAS) are synthetic derivatives of testosterone — compounds like testosterone enanthate, nandrolone, trenbolone, or oxandrolone. They are used medically for specific indications and non-medically to build muscle and strength.

Corticosteroids are anti-inflammatory drugs such as prednisolone, dexamethasone, or hydrocortisone. Doctors prescribe them for asthma, autoimmune conditions, allergies and many other problems. They are not anabolic steroids.

Here’s why this matters: when you search for “steroids and blood sugar”, much of what you find — hospital guidance, diabetes charity pages and medical papers — concerns corticosteroids. These drugs can raise blood glucose, sometimes substantially, and corticosteroid-associated hyperglycaemia is a recognised clinical problem.

Anabolic steroids act mainly through androgen receptors, and their effects on glucose metabolism are less well studied and less predictable. Findings from corticosteroid treatment cannot simply be applied to a testosterone cycle.

For the rest of this article, when we say “steroids”, we mean anabolic steroids. That’s what our readers ask about, and it’s where the information gap is.

How do anabolic steroids affect insulin sensitivity and glucose metabolism?

Anabolic steroids may affect glucose metabolism through several pathways, but the net effect is uncertain and depends on the compound, the dose and a person’s starting metabolic health. Proposed mechanisms include:

• Muscle glucose uptake. Skeletal muscle takes up much of the glucose circulating after a meal. Androgen exposure may affect insulin signalling in muscle tissue, but the size and direction of the effect in people using AAS are not well established. Claims that trenbolone is consistently the worst compound are based largely on user reports and animal data, not robust comparative human trials.
• Liver glucose output. The liver releases glucose between meals, while insulin helps regulate that process. Changes in insulin sensitivity could affect fasting glucose, but the contribution of AAS is not well quantified.
• Insulin sensitivity overall. If tissues become less responsive to insulin, the pancreas may need to produce more insulin to keep glucose in range. Fasting insulin can offer context, although it is variable and is not a standalone diagnostic test.

A study indexed on PubMed examined the effects of anabolic steroid administration on blood sugar and plasma insulin levels in humans (see the study record on PubMed), and later work on androgen exposure has continued to explore the link between supraphysiological androgen levels and altered glucose handling. The research base is limited compared with that for corticosteroids. Much of the human evidence comes from small studies and observational work, alongside animal models, so precise compound-by-compound estimates are not available for many substances.

Two practical distinctions matter more than any single proposed mechanism:

Acute vs. longer-term effects. Glucose changes, if they occur, may develop during use, but a predictable gradual rise over a set number of weeks has not been established. Appetite, body-fat distribution and diet can also change during a cycle. We covered these broader metabolic changes beyond glucose regulation in a separate article on how anabolic steroids affect appetite and metabolism.

Compound differences. There is not enough reliable human evidence to rank AAS by their effects on glucose control. Commonly discussed patterns include:

• Testosterone at moderate doses (roughly 300–500 mg per week, a range often reported for first cycles) may have little effect on glucose markers in some metabolically healthy people, but the evidence is not strong enough to treat this as predictable or safe.
• Trenbolone (often reported at 200–400 mg per week in non-medical use) is associated with user reports of worsening glucose markers, but comparative human data are lacking.
• Nandrolone has limited evidence on glucose outcomes in non-medical use; there is no sound basis for a precise ranking against trenbolone or testosterone.
• Oxandrolone has been studied in medical settings, but findings at clinical doses cannot be assumed to apply to supraphysiological use.

The takeaway: “anabolic steroids and blood sugar” isn’t one question — the answer may differ with the compound, dose and your starting metabolic health, and the evidence has important gaps.

Can testosterone and other anabolic steroids cause diabetes or increase diabetes risk?

This is the question that worries people most, so let’s be precise about what’s actually known and what isn’t.

What’s plausible: insulin resistance is one factor in the development of type 2 diabetes. If a compound worsens insulin sensitivity, repeated or prolonged exposure could add to risk, particularly in someone who already has risk factors such as a family history, excess visceral fat, poor sleep or pre-diabetes. The size of any additional risk from AAS is not established.

What we can’t claim: there is no strong body of long-term prospective research following otherwise healthy AAS users over many years to measure how much their diabetes risk changes. Most of what is known comes from shorter studies, observational work and general knowledge about insulin resistance.

What the available evidence and practical monitoring suggest:

• Dose and duration matter, but the relationship is not quantified. A single moderate testosterone cycle and years of high-dose, multi-compound use are very different exposures, but individual outcomes cannot be predicted from dose alone.
• Changes may improve after stopping, but timing varies. Whether repeated cycles cause lasting metabolic effects is not known. Do not assume a raised result will resolve on its own.
• Pre-existing risk matters. Undiagnosed pre-diabetes, substantial weight gain and use of growth hormone can all complicate glucose control.

Does human growth hormone (HGH) have different effects on insulin compared to anabolic steroids?

Yes — growth hormone is not an anabolic steroid, but it is often used alongside them, so its effects belong in this discussion.

Growth hormone can oppose some of insulin’s actions in muscle and liver tissue. Medical literature on growth hormone therapy and acromegaly, a condition involving chronic growth hormone excess, describes reduced insulin sensitivity and impaired glucose control. The effect varies between people and with dose and duration.

Practically, this means:

• Growth hormone can affect glucose control. Doses often cited in bodybuilding contexts are around 2–4 IU per day, with higher doses also reported. These are not medical recommendations; use can impair insulin sensitivity, and the response cannot be predicted from dose alone.
• Combining compounds may increase the burden. Testosterone, trenbolone and growth hormone can have different effects, but evidence does not allow a reliable prediction of the combined effect. Monitor glucose rather than assuming the stack will have a particular outcome.
• Adding insulin is dangerous. Some bodybuilders use exogenous insulin, but a dosing error or mismatch with food and activity can cause severe hypoglycaemia. Rising glucose is not a reason to self-prescribe insulin. Review the compounds with a clinician instead.

If your glucose is rising and you’re using growth hormone, it is one possible contributor, alongside diet, weight changes, other drugs and underlying metabolic health.

How long do blood sugar and insulin sensitivity changes last after stopping anabolic steroids?

There is no reliable, universal recovery window for glucose changes after stopping AAS. Results depend on the compounds used, ester clearance, cycle length, changes in body composition and underlying health. Do not rely on a general 4–8 week estimate as proof that a raised result will resolve.

It helps to separate drug exposure from other changes that happen during a cycle:

• Potentially reversible changes: if a drug contributed to a change in insulin sensitivity, stopping it may help, but the timing and degree of recovery are not established for AAS use.
• Changes that may persist: visceral fat gained during a bulk, prolonged calorie surplus, poor sleep and reduced fitness can continue to affect glucose after the drugs have cleared.
• Long-term use: the metabolic effects of near-continuous exposure over years are not well quantified. Persistent abnormal results need assessment rather than an assumption that they are temporary.

Factors that can influence your results after stopping include:

• Cycle length and dose — greater or longer exposure may mean more opportunity for changes, although the relationship is not predictable.
• Compounds used — long-acting preparations and growth hormone have different clearance and effects; a single retesting date will not suit everyone.
• Your baseline — someone starting with normal glucose may have a different risk profile from someone already near the pre-diabetes threshold.
• What you do afterwards — diet, physical activity, sleep and body-fat management influence glucose control independently of AAS.

A practical approach is to repeat fasting glucose around 6–8 weeks after the last long-acting compound, and discuss abnormal results with a clinician. HbA1c reflects roughly the preceding 2–3 months, so it may not fully reflect a recent change at that point; a later repeat may be more informative. Do not wait for a planned retest if glucose is in the diabetic range or you have symptoms such as excessive thirst, frequent urination or unexplained weight loss.

What should people with existing diabetes or pre-diabetes know before using anabolic steroids?

This section matters more than any other, and pre-diabetes is often undiagnosed. Someone may already have impaired glucose regulation before using AAS.

If you have pre-diabetes (fasting glucose 5.6–6.9 mmol/L, or 100–125 mg/dL; HbA1c 42–47 mmol/mol, or 5.7–6.4%): you are starting with impaired glucose regulation. A further rise could put results into the diabetes range. The risk from AAS is not precisely known; growth hormone and compounds associated with concerning readings warrant particular caution. Discuss abnormal baseline results with a clinician before making decisions about use.

If you have type 2 diabetes: AAS use can complicate glucose management, particularly if your glucose control changes while taking medication. Some specific issues:

• Metformin has no established direct interaction with AAS, but a change in glucose control may mean your treatment needs review. Medication changes are a clinical decision.
• Insulin (for type 1 or insulin-treated type 2 diabetes) carries a particular risk: changes in insulin sensitivity can make an established insulin regimen unsafe and may lead to hypoglycaemia or high glucose.
• Type 1 diabetes deserves special mention: glucose control depends on matching insulin to food, activity and insulin sensitivity. Unpredictable changes make that harder.

This is not a situation to manage alone. More frequent glucose checks may be needed, and your diabetes team should know about AAS or growth hormone use so they can assess risks and treatment. Never change prescription doses based on online advice.

How to monitor blood glucose and insulin markers while using anabolic steroids?

Metabolic monitoring relies on a few standard tests taken under consistent conditions. Your GP or diabetes team can help interpret abnormal results.

The core markers:

HOMA-IR combines fasting glucose and fasting insulin into an estimate of insulin resistance. It can add context, but it is not a diagnostic test and a single result should not be treated as a clear warning threshold. Fasting glucose and HbA1c have established clinical interpretation ranges; use those and your clinician’s assessment to guide follow-up.

A practical testing schedule:

• Baseline — check fasting glucose and HbA1c before use. Fasting insulin and HOMA-IR may provide extra context. Follow the laboratory’s instructions and record the results.
• Mid-cycle — around weeks 4–6 of a planned 10–12 week cycle, repeat fasting glucose; consider repeating insulin if it was measured at baseline. With abnormal baseline results or growth hormone use, monitor more frequently with clinical guidance. A home meter can show day-to-day patterns but does not diagnose diabetes.
• End of cycle / early PCT — repeat fasting glucose if earlier results were abnormal or have changed. HbA1c may be too early to reflect a short-term change.
• After stopping — repeat fasting glucose around 6–8 weeks after the last long-acting compound; consider HbA1c after about three months, or sooner if a clinician advises it. Follow up abnormal results rather than assuming they will resolve.

How to read what you see: small changes can reflect normal day-to-day or laboratory variation, so repeat an unexpected result under consistent conditions. In UK units, fasting glucose from 5.5 to 6.9 mmol/L warrants follow-up; 7.0 mmol/L or above is in the diabetes range and should be confirmed promptly by a clinician. If you have symptoms of high glucose, seek medical advice without waiting for a repeat test. Do not use HOMA-IR alone to decide whether to stop or continue a compound.

For help reading these results in context with the rest of your panel, we’ve put together a detailed guide on how to interpret glucose and insulin markers in your blood work — including what fasting means in practice and how lab-to-lab variation affects your numbers. And if you want comprehensive guidance on managing metabolic health during anabolic steroid use beyond the glucose panel — lipids, liver enzymes and blood pressure — that resource covers the full picture.