Newly diagnosed and unable to see a health care professional due to covid-19

[Megzhaych]

Hi I care for my mother who in the last week has been diagnosed with steroid induced diabetes. They have started her on a tablet to try and control it for now as they don’t want her to see a healthcare professional to show her insulin as she is already extremely high risk due to other existing health conditions.

she got a meter from a family member last night and her blood sugar today has just been climbing continually going from 8 before her breakfast to 18.4 after her lunch.
What can we do to try and bring this down or control it a little more? She’s been getting headaches dry mouth slurred so speach etc. We are at a loss of what to do as nothing has been explained to us at all. She lives alone and I’m her carer, I see her every day but with this new diagnosis and high levels I’m frightened to leave her.

 

[Brunneria]

Hi and welcome!

I will tag in two experienced members who both have histories of steriod induced, and long term management of it.
@xfieldok @JohnEGreen
My understanding is that they have both used a combination of diet and medication to get control of their blood glucose.

In the meantime, just so that we have a bit more information, what does your mother eat, breakfast, lunch, dinner and snacks?

It is a nervewracking time, being diagnosed, add in the coronavirus, and everything being up in the air with health appointments, and social distancing, and I can quite understand how worrying it must all be for you both.

Are you and your mother in the UK? Or elsewhere? And what level of social distancing are you practicing?

Oh, and what is the tablet she has been prescribed?

 

[Squire Fulwood]

Since you can't see a HCP you will have to deal with the diet side of things which you should be able to do without help. Do not give her carbohydrates to eat or drink or at least cut down on them severely. Carbohydrate laden food and the four horsemen , sugar, flour, potato and rice so cut down on these. Processed food comes in packets so check the carbohydrate content on the label on the back of the packet. Interestingly, things like corned beef, ham are very low in carbohydrates.

Cut down on root vegetables but eat as much as you like of the others. Don't drink fizzy drinks or any with added sugar in.

So for the moment until you get help she will be eating meat and salads or meat and veg and mostly drinking beverages with no sugar in and quite a lot of water.

 

[xfieldok]

@Megzhaych hi and welcome.

Is your mum still on steroids and what dosage?

I kicked T2 into touch be eating a keto diet. Then I was diagnosed with an Autoimmune condition and they put me on steroids.

So, blood glucose went to stupid levels. They messed me around for ages and eventually sent me to a Specialist Diabetic Nurse, she immediately put me on insulin. It didn't really help that much and I jumped up and down and eventually I was given a short acting insulin, the type that T1s use with food. I got no training. There is an art to it.

The nurses at the surgery were like deer in the headlights, they couldn't get their heads around the fact I needed the insulin to control the steroids not carbs.

By the way, the steroids put 2stone on me. I was eating keto all the time, otherwise I would have put on considerably more.

In the first instance, I would phone the surgery and ask them if there is a Specialist Diabetes nurse attached to the surgery and can you get an urgent telephone appointment. If she agrees to a long acting insulin, I was given Humulin I, ask for a short acting insulin to top up as needed. I used Novorapid.

Administering the injections is a piece of cake and nothing to worry about.

Anything you want to ask, go right ahead.

 

[Megzhaych]

Hi and welcome!

I will tag in two experienced members who both have histories of steriod induced, and long term management of it.
@xfieldok @JohnEGreen
My understanding is that they have both used a combination of diet and medication to get control of their blood glucose.

In the meantime, just so that we have a bit more information, what does your mother eat, breakfast, lunch, dinner and snacks?

It is a nervewracking time, being diagnosed, add in the coronavirus, and everything being up in the air with health appointments, and social distancing, and I can quite understand how worrying it must all be for you both.

Are you and your mother in the UK? Or elsewhere? And what level of social distancing are you practicing?

Oh, and what is the tablet she has been prescribed?

Thank you very much for the response. To be honest she probably does usually eat a lot of carbohydrates, toast cereal or porridge usually for breakfast. A ham salad wrap for lunch and meals like a hike made spaghetti bolognaise or a curry etc for tea. We are in the uk north east England. My mam is in 12 weeks of isolation as she’s considered very high risk due to copd and other health issues. I’m doing her shopping and everything else for her. She was given metaformin but they’ve advised of a change to something else beginning with a g I can’t remember the name exactly.

 

[KarenGG]

I am new to all this, went into hospital with Sepsis (again) and DKA (not aware diabetic) right before the madness hit. I was discharged 9pm 3 weeks later with a million questions and can’t get straight answer! I have steroid connected diabetes along with several other pancreatic/ liver previous illnesses and no real answers.
I was told by hospital to test 3 times daily and take 500mg metformin to start with after being on reduced insulin. First my gp said don’t test, then said absolutely test. My blood sugar keeps rising, metformin increased to twice a day. My average (even fasting ) blood sugar is 11.x and then rises to 15/17 rest of day. Other gp says don’t test regular and wait 6/8 weeks then they will increase my medication.

It was expected I’d be seen at doctors on semi regular basis in case I needed insulin but of course that hasn’t happened, I’ve had 3 phone calls with the diabetic nurse, no bloods that were requested by hospital as you can’t get appointments for these. Hospital diabetic nurse said get further advise if bs 15+ community say 20+.
No real advise other than that! I’m so confused

 

[Megzhaych]

@Megzhaych hi and welcome.

Is your mum still on steroids and what dosage?

I kicked T2 into touch be eating a keto diet. Then I was diagnosed with an Autoimmune condition and they put me on steroids.

So, blood glucose went to stupid levels. They messed me around for ages and eventually sent me to a Specialist Diabetic Nurse, she immediately put me on insulin. It didn't really help that much and I jumped up and down and eventually I was given a short acting insulin, the type that T1s use with food. I got no training. There is an art to it.

The nurses at the surgery were like deer in the headlights, they couldn't get their heads around the fact I needed the insulin to control the steroids not carbs.

By the way, the steroids put 2stone on me. I was eating keto all the time, otherwise I would have put on considerably more.

In the first instance, I would phone the surgery and ask them if there is a Specialist Diabetes nurse attached to the surgery and can you get an urgent telephone appointment. If she agrees to a long acting insulin, I was given Humulin I, ask for a short acting insulin to top up as needed. I used Novorapid.

Administering the injections is a piece of cake and nothing to worry about.

Anything you want to ask, go right ahead.

thank you very much for the response.

My mam has COPD and fybromyalgia along with mild heart failure. She is now steroid dependant and is currently on 20mg.

I will look into the keto diet as I’ve heard good things about it.

thank you very much for your advice I will see if I can get a telephone appointment with a diabetic nurse

 

[xfieldok]

Make sure it is a Specialist nurse, there is a difference.

If the nurse agrees with the insulin, ask them if they would consider prescribing a Freestyle libre. Even if it is just for the time it takes to get things under control. Your mum is going to need a lot of tests and may get sore fingers.

 

[Megzhaych]

I am new to all this, went into hospital with Sepsis (again) and DKA (not aware diabetic) right before the madness hit. I was discharged 9pm 3 weeks later with a million questions and can’t get straight answer! I have steroid connected diabetes along with several other pancreatic/ liver previous illnesses and no real answers.
I was told by hospital to test 3 times daily and take 500mg metformin to start with after being on reduced insulin. First my gp said don’t test, then said absolutely test. My blood sugar keeps rising, metformin increased to twice a day. My average (even fasting ) blood sugar is 11.x and then rises to 15/17 rest of day. Other gp says don’t test regular and wait 6/8 weeks then they will increase my medication.

It was expected I’d be seen at doctors on semi regular basis in case I needed insulin but of course that hasn’t happened, I’ve had 3 phone calls with the diabetic nurse, no bloods that were requested by hospital as you can’t get appointments for these. Hospital diabetic nurse said get further advise if bs 15+ community say 20+.
No real advise other than that! I’m so confused

It’s funny you should say that as my mam first ever had high sugar when she was in hospital with sepsis. When she was discharged no more was said about it then every time she’s been in hospital since with chest problems he left sugar has been high but they’ve never said she was actually diabetic until a district nurse cane to do some bloods last week after her complaining of bad headaches. Dry mouth, dizziness, nausea, slurred speach etc. She’s only spoken to a GP and no one has told her anything really they didn’t even give her a machine to test her blood. Just stuck her on metaformin and that was that

 

[xfieldok]

If she gets insulin, she will get a meter. She should have one if she is on medication that lowers her blood glucose eg glicazide.

You will find that most Drs and nurses know next to nothing about diabetes and steroids.

 

[EllieM]

It’s funny you should say that as my mam first ever had high sugar when she was in hospital with sepsis.

Illness and steroids are both notorious for raising blood sugars. As a T1 diabetic (I inject all my insulin and produce no insulin at all) I expect my insulin needs to go up drastically if I become ill.

If the drug beginning with g is gliclazide then you can remind them that they should give her a meter and testing strips. Gliclazide is a commonly used drug for diabetics, it stimulates the pancreas to produce extra insulin. As such, it has the potential to give you low blood sugar (hypo) which needs to be treated with sugar immediately, and is the reason why gliclazide users are advised to have a meter by the NHS. (Most non insulin using diabetics don't qualify for meters, which most of us on here believe to be a cost saving exercise, rather than a medical best practice one.)

Good luck with your mother.

 

[Daibell]

Hi. I agree with the other posts to keep the carbs well down and having Gliclazide should also help but be aware that if the dose is too high she may go hypo due to very low blood sugar.

 

[Sgathach]

I am new to all this, went into hospital with Sepsis (again) and DKA (not aware diabetic) right before the madness hit. I was discharged 9pm 3 weeks later with a million questions and can’t get straight answer! I have steroid connected diabetes along with several other pancreatic/ liver previous illnesses and no real answers.
I was told by hospital to test 3 times daily and take 500mg metformin to start with after being on reduced insulin. First my gp said don’t test, then said absolutely test. My blood sugar keeps rising, metformin increased to twice a day. My average (even fasting ) blood sugar is 11.x and then rises to 15/17 rest of day. Other gp says don’t test regular and wait 6/8 weeks then they will increase my medication.

It was expected I’d be seen at doctors on semi regular basis in case I needed insulin but of course that hasn’t happened, I’ve had 3 phone calls with the diabetic nurse, no bloods that were requested by hospital as you can’t get appointments for these. Hospital diabetic nurse said get further advise if bs 15+ community say 20+.
No real advise other than that! I’m so confused

Hi Karen, I'm new too, barely 2 months since diagnosis. I was on my own at first too, but there is tons of information out there. A lot of it on this message board but I just kept googling for different key words and read more and more books.
Hopefully you can find information from people in a similar situation to you.

 

[tauromesa]

New on the forums as well, I was diagnosed with prediabetes, it seems to run on the family. So far so good. Haven't been able to visit my specialist again due to the Covid situation. I'm pretty active physically speaking, blessed with the fact that I haven't been directed to take any medication. Funny thing is, the most sugar intake I have comes from coffee, and honestly that's what I've been struggling the most in terms of changing my behavior to suit the improvement of my diagnosis. Thanks for sharing your experience as well, and I hopefully expect that your mother improves somewhat through time.

 

[Resurgam]

New on the forums as well, I was diagnosed with prediabetes, it seems to run on the family. So far so good. Haven't been able to visit my specialist again due to the Covid situation. I'm pretty active physically speaking, blessed with the fact that I haven't been directed to take any medication. Funny thing is, the most sugar intake I have comes from coffee, and honestly that's what I've been struggling the most in terms of changing my behavior to suit the improvement of my diagnosis. Thanks for sharing your experience as well, and I hopefully expect that your mother improves somewhat through time.

Ah - but what amount of 'healthy' starches do you eat - that is the elephant in the room. Diabetes is the inability to deal with carbohydrate, and for many people these days that is all about the bread, potatoes, cereals and fruit eaten. My diet before diagnosis was based on wholewheat and brown carbs - total disaster. I now eat a diet totally opposite to all the recommendations - it has meat, but also seafood, eggs, cheese, full fat yoghurt and nuts. I have stir fries, roast veges and salads, but only up to the amount I can cope with.
By the time we are getting back to anything normal you might have solved the problem completly.