Steroid medication increases glucose??

[James Lyme]

Hi all. I hope you can give me some advice.
I am 27, T1, diagnosed almost 2 years ago and have very good control. Last a1c was 5.1%. I use Apidra and Lantus and control my diet vey well.
I have recently been diagnosed with mild arthritis and been given prednisolone, a steroid medication. I am taking 30mg per day and am on a weeks trial which started yesterday. I noticed about 8 hours after taking them my blood glucose increased from 5.0mmol to 10.0mmol in a short period of time, something very unusual for me. Knowing how I react to my insulin I took 2u correction, had no food to see how it responds and 2 hours later it had decreased to. 8.8mmol, again, something very unusual for me as I would expect it to be about 5.0 afterwards.
I understand this medication can increase glucose levels but since I have no experience of taking it wondered if there was any advice someone could give me about changing doses or best times of day to take it.
Thanks in advance!

 

[susyhi02]

Hi all. I hope you can give me some advice.
I am 27, T1, diagnosed almost 2 years ago and have very good control. Last a1c was 5.1%. I use Apidra and Lantus and control my diet vey well.
I have recently been diagnosed with mild arthritis and been given prednisolone, a steroid medication. I am taking 30mg per day and am on a weeks trial which started yesterday. I noticed about 8 hours after taking them my blood glucose increased from 5.0mmol to 10.0mmol in a short period of time, something very unusual for me. Knowing how I react to my insulin I took 2u correction, had no food to see how it responds and 2 hours later it had decreased to. 8.8mmol, again, something very unusual for me as I would expect it to be about 5.0 afterwards.
I understand this medication can increase glucose levels but since I have no experience of taking it wondered if there was any advice someone could give me about changing doses or best times of day to take it.
Thanks in advance!

 

[susyhi02]

I have been taking prednosolone constantly for the past 8 years and was diagnosed with type 2 diabetes 7 years ago and got my insulin levels sorted after trying different types of insulin but if I have an infection and my steroids are raised my sugar levels are hard to control and I check my levels 3 times a day and try and work out how many units to take. I find it a bit hit and miss
It's the same if I take antibiotics i have to adjust my insulin I have not found a quick fix xx

 

[James Lyme]

I have been taking prednosolone constantly for the past 8 years and was diagnosed with type 2 diabetes 7 years ago and got my insulin levels sorted after trying different types of insulin but if I have an infection and my steroids are raised my sugar levels are hard to control and I check my levels 3 times a day and try and work out how many units to take. I find it a bit hit and miss
It's the same if I take antibiotics i have to adjust my insulin I have not found a quick fix xx

Do you mean if I use different insulins it might help keep the ranges down?
Also, my doctor told me about plenty of side effects. Have you experienced anything since being on the medication?

 

[CarbsRok]

Hi James,
steroids do cause your blood sugar too rise that is one of the unfortunate side effects of it An endocrinologist told me years ago that the it takes about 2 units of insulin too 1mg of pred to keep your numbers down. Obviously this was general info so you need to adjust your insulin so you are under control. Personally I find once taken in the morning blood sugars start to rise very slowly about 10 AM. I use a pump so can obviously set my basal to compensate for this.
You need to look at increasing your basal and also your meal time bolus. Lots of testing and record keeping will help no end in this dept.

 

[James Lyme]

Hi James,
steroids do cause your blood sugar too rise that is one of the unfortunate side effects of it An endocrinologist told me years ago that the it takes about 2 units of insulin too 1mg of pred to keep your numbers down. Obviously this was general info so you need to adjust your insulin so you are under control. Personally I find once taken in the morning blood sugars start to rise very slowly about 10 AM. I use a pump so can obviously set my basal to compensate for this.
You need to look at increasing your basal and also your meal time bolus. Lots of testing and record keeping will help no end in this dept.

Hi CarbsRok.
Thanks for your reply. I understand the ratio was generalised but would that mean taking 60u of insulin with the medication, or waiting a few hours and taking it then. Also, I noticed being high when waking, not before bed. In that case I would look at changing my basal first.
Do you think it worth holding out a week before making any changes as I might be taken off next week and the basal will last longer. So just keep checking and correcting?
What time do you take it in the morning so I have an idea about the delay before the rise.
Thanks.

 

[susyhi02]

"James Lyme, post: 616848, member: 91261"]Do you mean if I use different insulins it might help keep the ranges down?
Also, my doctor told me about plenty of side effects. Have you experienced anything since being on the medication?[/QUOTE]
My diab

 

[CarbsRok]

Hi CarbsRok.
Thanks for your reply. I understand the ratio was generalised but would that mean taking 60u of insulin with the medication, or waiting a few hours and taking it then. Also, I noticed being high when waking, not before bed. In that case I would look at changing my basal first.
Do you think it worth holding out a week before making any changes as I might be taken off next week and the basal will last longer. So just keep checking and correcting?
What time do you take it in the morning so I have an idea about the delay before the rise.
Thanks.

Hi CarbsRok.
Thanks for your reply. I understand the ratio was generalised but would that mean taking 60u of insulin with the medication, or waiting a few hours and taking it then. Also, I noticed being high when waking, not before bed. In that case I would look at changing my basal first.
Do you think it worth holding out a week before making any changes as I might be taken off next week and the basal will last longer. So just keep checking and correcting?
What time do you take it in the morning so I have an idea about the delay before the rise.
Thanks.

Hi James, you do need to think about increasing your basal as I said keep good records to you can refer back to them. Pred does cause insulin resistance
Taking 60 units in one shot is def not a good idea. Trying to play catch up with extra bolus never works, I have always found sort the basal and then use corrections to sort the rest out.
You will probably find your carb ratio will change as well.
Please what ever you decide to do make sure you have plenty of hypo treatment at the ready.
I can not see you being kept on steroids long term esp at that level due to the side effects you will encounter.

 

[James Lyme]

Hi James, you do need to think about increasing your basal as I said keep good records to you can refer back to them. Pred does cause insulin resistance
Taking 60 units in one shot is def not a good idea. Trying to play catch up with extra bolus never works, I have always found sort the basal and then use corrections to sort the rest out.
You will probably find your carb ratio will change as well.
Please what ever you decide to do make sure you have plenty of hypo treatment at the ready.
I can not see you being kept on steroids long term esp at that level due to the side effects you will encounter.

Hi CarbsRok.
I wasn't suggesting taking 60u, was just trying to work out what I would take as to the generalised ratio you gave of 2 to 1. Today I've been chasing with bolus but will increase my basal tonight and keep a record of how I respond.
Do you know how long it takes for the effects on glucose to wear off? So if you take the pred at 9am, it will have finished raising the glucose by what time approximately?
My carb ratio has fluctuated daily ever since being diagnosed. I have performed all the tests and spoken to many endos and no one can tell me why, I just keep a close eye on it.
Lastly, is 30mg a high dose? I have read of all the possible side effects and am feeling some minor ones already such as feeling jittery, almost the feeling of a hypo but my glucose is 11.1 at the time.
Thanks.

 

[jubbtravel]

Hi james

I take pred for addisons only 10 mgs but have to take more insulin, my doctor says it peaks in the afternoon if you take all your does in the morning so my lunch time novorapid is more than my morning and evening. 30 is quite a bit dose I am giving that for an asthma attack for a few days then lower it bit by bit.

Lesley

 

[Loobles]

It's well known for raising blood glucose...even as a young non-diabetic in the days when my BG was in the 3's when fasting, I was getting near 10 when I had to have prednisolone for my chest. I never thought anything of it at the time, but I wonder now if that was the first sign something was up. Hmmm...

 

[James Lyme]

Hi james

I take pred for addisons only 10 mgs but have to take more insulin, my doctor says it peaks in the afternoon if you take all your does in the morning so my lunch time novorapid is more than my morning and evening. 30 is quite a bit dose I am giving that for an asthma attack for a few days then lower it bit by bit.

Lesley

Hi jubbtravel
What time do you take your pred in the morning and what time do you generally notice spikes in glucose? I'm not experiencing much of a pattern.
Thanks.

 

[CarbsRok]

Hi james

I take pred for addisons only 10 mgs but have to take more insulin, my doctor says it peaks in the afternoon if you take all your does in the morning so my lunch time novorapid is more than my morning and evening. 30 is quite a bit dose I am giving that for an asthma attack for a few days then lower it bit by bit.

Lesley

Flipping heck Lesley that is one heck of a lot of pred for Addison's. It's no wonder you need more steroids for it. At the most if you are on pred replacement the normal dose is 6mg for top whack.
I use 5mg plus 5mg of HC for a kick start in the morning.
As I've said for me James the slow onset of a rise starts at about 10 AM peaks at about 12 though and then drops right down by 4 pm. From 8 pm I only use 0.025U until midnight.
I forgot to tell you James I take my steroids at between 7 and 8 AM.

 

[jubbtravel]

Hi, I have changed now to Hydro but still on 40 and trying to get lower, before I took 7.5 for my addisons and 2.5 for my arthritis, so now I am doing 20, 10, 10 going to go down to 5 in the evening. I take the first does before I get up at around 7.30. I don't produce any cortisol and the endo said not to go below 7.5 pred which I think is 30 hydro. My arthritis is quite bad at the mo especially my hands, knee and back and can't take the strong co-codamol as it gives me headaches and makes me tired and dizzy. I also struggle with asthma so sometimes need more for that. At the mo I am struggling again with insulin the porcine 70/30 is bloating me badly and making my hands and feet swell, do you have any problems with the bovine.
thanks

lesley

 

[CarbsRok]

Hi, I have changed now to Hydro but still on 40 and trying to get lower, before I took 7.5 for my addisons and 2.5 for my arthritis, so now I am doing 20, 10, 10 going to go down to 5 in the evening. I take the first does before I get up at around 7.30. I don't produce any cortisol and the endo said not to go below 7.5 pred which I think is 30 hydro. My arthritis is quite bad at the mo especially my hands, knee and back and can't take the strong co-codamol as it gives me headaches and makes me tired and dizzy. I also struggle with asthma so sometimes need more for that. At the mo I am struggling again with insulin the porcine 70/30 is bloating me badly and making my hands and feet swell, do you have any problems with the bovine.
thanks

lesley

Hi Lesley, sorry to hear you are having so many problems, not good. I've used bovine insulin for almost 50 years and don't have a problem with it.

 

[James Lyme]

Thanks for your responses. Much appreciated.