steroids n stuff and ducks in puddles

[pleinster]

Hi...I'm on a steroid called Prednisolone following a kidney transplant and was diagnosed back in April with Type 2 as a consequence. It's a fairly common consequence. The drug has been cut from 20mg down to 5mg and may be cut further 1 year after transplant but it's something there's a lot of hesitancy about as there's always the risk of rejection. Anyway, I take the drug with other meds in the morning around 8am (after I test my BS) and it is causing a spike (which I expected) that peaks around midday. The peak was about 14.5 but since starting a low carb diet, I have got that down below 9.0. In fact, all other readings are now down nicely to less than 8.0..and its the only one spoiling my average. Anyone got experience here? I look forward to a response from mrspuddleduck, who has different experience with steroids to me Any advice, or anything really, would be helpful.

 

[CarbsRok]

Hi Pleinster,
I take prednisolone due to having Addison's disease and like you find I have a spike towards lunch time. Being type1 it's easier for me to deal with as I just increase my insulin to cope with it.
Can you do any exercise about an hour before the steroid spike hits home?
If low carbing doesn't eliminate the spike perhaps consider a talk with your health care team about having some bolus insulin at lunchtime to help you out. Personally I would have thought that would be an option rather than the complications from high blood sugars.
Wishing you the best.

 

[pleinster]

Hi Pleinster,
I take prednisolone due to having Addison's disease and like you find I have a spike towards lunch time. Being type1 it's easier for me to deal with as I just increase my insulin to cope with it.
Can you do any exercise about an hour before the steroid spike hits home?
If low carbing doesn't eliminate the spike perhaps consider a talk with your health care team about having some bolus insulin at lunchtime to help you out. Personally I would have thought that would be an option rather than the complications from high blood sugars.
Wishing you the best.

Thanks for that. I was shopping to avoid insulin for as long as possible if not completely, but point taken. I think so long as I can keep the spike down to under 8.5..I'll persist...maybe. Do you think that's still too high - its now my only real point of the day above 7.5.

 

[CarbsRok]

Thanks for that. I was shopping to avoid insulin for as long as possible if not completely, but point taken. I think so long as I can keep the spike down to under 8.5..I'll persist...maybe. Do you think that's still too high - its now my only real point of the day above 7.5.

My personal opinion is that your numbers are still too high but you have made massive improvements so very positive What levels are you getting on waking and 2 hours after meals?

 

[fred1234]

I take 20mg maintenance dose of steroids daily and yes they do spike bg !!! Mines spike pm. I take 14units novo mix 30 at lunch time. I take very little for lunch normally baby belle an Greek yoghurt and my bg are normally at 9ish by tea time. They come back down again in the evening to an acceptable leVel. Morning before breakfast is normally in the 5s. I worry constantly bout m bg being in the higher bracket but I have other medical condition that dictate the amount of steroids, sometimes I have much higher dose and antibiotics too as suffer frequently from infection

 

[mrspuddleduck]

Hi @pleinster , sorry didn't pick up your thread before! I've been steroid dependant for way over 10 years now. Your experience sounds fairly typical where your blood sugars increase as the day goes on. Mine continue to climb and are regularly in the terns in the evening - its so frustrating! Will you have to remain on steroids or is there any chance of coming off them in the future? Sue xx

 

[pleinster]

My personal opinion is that your numbers are still too high but you have made massive improvements so very positive What levels are you getting on waking and 2 hours after meals?

Hi. Waking levels around 8am are generally about 6.5 atm, but coming down to high 5s. My midday steroid spike was 8.3. before dinner 6.1, 2.5 hours later 6.4. Sometimes though, my post meal reading can be around 2-2.5 mmols higher than pre-meal. Not perfect, I know, but better than it was.

 

[pleinster]

Hi @pleinster , sorry didn't pick up your thread before! I've been steroid dependant for way over 10 years now. Your experience sounds fairly typical where your blood sugars increase as the day goes on. Mine continue to climb and are regularly in the terns in the evening - its so frustrating! Will you have to remain on steroids or is there any chance of coming off them in the future? Sue xx

Hi Sue. Not sure yet about whether or not I will remain on the Prednisolone for life. I think it depends on doctors weighing the risk of rejection against the potential damage done to by diabetes. I am on anti-rejection drugs too (for life) so it's a possibility I may come off the steroids, but - it's a tough shout. the one thing I don't want is rejection of my new kidney! I avoided dialysis...and don't want to go down that road if at all possible. What strategies if any have you tried to lower your spike?

 

[CarbsRok]

Hi. Waking levels around 8am are generally about 6.5 atm, but coming down to high 5s. My midday steroid spike was 8.3. before dinner 6.1, 2.5 hours later 6.4. Sometimes though, my post meal reading can be around 2-2.5 mmols higher than pre-meal. Not perfect, I know, but better than it was.

Hi Pleinster,
Your results are getting better and better so a very well done in that dept.
Hopefully things will improve even more pre and post lunch.
As people with diabetes can have kidney problems due to high blood sugars do always consider this in your management plan and do not be afraid of insulin if that's what it takes to keep your numbers down in the long term. I've been on steroids for 13 years now so have learnt how to deal with them for my own needs obviously we are all different

 

[mrspuddleduck]

Hi Sue. Not sure yet about whether or not I will remain on the Prednisolone for life. I think it depends on doctors weighing the risk of rejection against the potential damage done to by diabetes. I am on anti-rejection drugs too (for life) so it's a possibility I may come off the steroids, but - it's a tough shout. the one thing I don't want is rejection of my new kidney! I avoided dialysis...and don't want to go down that road if at all possible. What strategies if any have you tried to lower your spike?

To be honest its complicated for me. Because I have brittle diabetes my blood sugars are hard to control anyway and the steroids just make it worse! I'm currently on a fixed dose long/short acting insulin rather than bolusing which so far has been the most effective. But its far from perfect! I spent an awful year trying to reduce the steroids but only managed to reduce by 2mgs when the docs decided enough was enough and deemed me steroid dependant! Sadly I don't think I have any real strategies, I do however pat myself on the back and do a little dance round the room if I ever get my blood sugars below 10 in the day and I don't hypo at night!!! Sue xx

 

[pleinster]

Th

Hi Pleinster,
Your results are getting better and better so a very well done in that dept.
Hopefully things will improve even more pre and post lunch.
As people with diabetes can have kidney problems due to high blood sugars do always consider this in your management plan and do not be afraid of insulin if that's what it takes to keep your numbers down in the long term. I've been on steroids for 13 years now so have learnt how to deal with them for my own needs obviously we are all different

Thanks for the encouragement. Much appreciated.

 

[pleinster]

To be honest its complicated for me. Because I have brittle diabetes my blood sugars are hard to control anyway and the steroids just make it worse! I'm currently on a fixed dose long/short acting insulin rather than bolusing which so far has been the most effective. But its far from perfect! I spent an awful year trying to reduce the steroids but only managed to reduce by 2mgs when the docs decided enough was enough and deemed me steroid dependant! Sadly I don't think I have any real strategies, I do however pat myself on the back and do a little dance round the room if I ever get my blood sugars below 10 in the day and I don't hypo at night!!! Sue xx

Hey Sue. well, I hope there's lots of little dances round the room in the immediate future. Paul x

 

[nickm]

I am also T1 on HC and Prednislolone for Addisons. You can see my story in much more detail at t1diabetesafter55.blogspot.com.au
Agree with carbsRok comments. Also consider splitting your steroid dose.

 

[pleinster]

I am also T1 on HC and Prednislolone for Addisons. You can see my story in much more detail at t1diabetesafter55.blogspot.com.au
Agree with carbsRok comments. Also consider splitting your steroid dose.

Nice blog, Nick. Think I'll follow you (in the non-creepy sense). Thanks.