very high blood glucose. Type1.

[alannemo56]

Hi
My names Alan and I have had the worst 2 days of my life since getting a steroid injection yesterday my glucose levels
are in excess of 33.3 most of the night and I cant contain them any lower than 23.5.
Called NHS 24 who sent me to the local A&E where a Young Doctor told me to stop reacting to my high counts by injecting extra insulin over and beyond my pump as this would be causing me to hypo in my sleep, taking no notice to the fact that I have not slept at all last night being up every hour try to bring my levels down.
thought I had it on the run today until tea time when I started rising from 23.2 to 30.6 so looks like another sleepless night.
I have only eaten 2 meals in the last 36 hours.
Any help will be greatly appreciated.

 

[Diakat]

Hi Alan,
No constructive advice but hope by replying you get bumped up for a reply. Possibly an infection? Apart from feeling rubbish from the sugars have you any other symptoms? I'd be tempted to return to hospital as numbers still high.

 

[Rickmac1988]

Hi Alan,

I have a pump and I've had it in the past when my blood glucose won't drop below 20 or higher. One thing that worked for me once was changing the site of the infusion set. Perhaps where you have it at the minute has become immune to the insulin? Just a thought anyway. Hope you're able to reduce your blood soon.

Rick

 

[catapillar]

I imagine @alannemo56 realises he is probably running high due to the steroid injection & is after advice on how to bring it down safely. I don't use a pump, but would think that whatever your sick day rules usually are could be applied in this situation (I think @noblehead uses a pump so might be able to help more)? Keep hydrated & I hope you manage to sleep tonight. If you do think you might have over treated a high, set an alarm to test for lows & make sure to treat that like normal.

 

[alannemo56]

Hi Alan,
No constructive advice but hope by replying you get bumped up for a reply. Possibly an infection? Apart from feeling rubbish from the sugars have you any other symptoms? I'd be tempted to return to hospital as numbers still high.

Hi Diakat
Thanks for getting back to me, unfortunately no other symptoms going to try and ignore it and see what happens been type one for 30 years now si hopefully keep an eye on the keytones and pray they stay low

 

[alannemo56]

I imagine @alannemo56 realises he is probably running high due to the steroid injection & is after advice on how to bring it down safely. I don't use a pump, but would think that whatever your sick day rules usually are could be applied in this situation (I think @noblehead uses a pump so might be able to help more)? Keep hydrated & I hope you manage to sleep tonight. If you do think you might have over treated a high, set an alarm to test for lows & make sure to treat that like normal.

Thanks catapillar but as last night just keeping an eye on my ketones glucose still playing silly beggers no need to set alarm no matter what I do it dont want to come into reasonable numbers as long as ketones dint rise sharply I'll give up on sleep for a while and just have to go with it

 

[noblehead]

@alannemo56, if your sure it isn't a issue with a set/ insulin then just follow the Sick Day Rules until such times that your bg levels return to normal, steroid injections can cause high bg and usually a gp/consultant will warn you about this before administering the drug.

http://www.leicestershirediabetes.org.uk/uploads/documents/Type1 Sick_day_rules_InsulinV3.pdf

 

[TorqPenderloin]

I imagine @alannemo56 realises he is probably running high due to the steroid injection & is after advice on how to bring it down safely. I don't use a pump, but would think that whatever your sick day rules usually are could be applied in this situation (I think @noblehead uses a pump so might be able to help more)? Keep hydrated & I hope you manage to sleep tonight. If you do think you might have over treated a high, set an alarm to test for lows & make sure to treat that like normal.

I would agree. It seems quite obvious the steroids are the culprit.

Unfortunately, many steroids (and especially glucocorticoids) are absolute h*ll on your body. In someone without T1, they can hinder your beta-cells' ability to produce insulin, and in addition can make your cells extremely resistant to insulin. In so many words, it's the equivalent of having both T1 and T2 at the same time.

As far as what to do about it? That's a very dangerous question and one we aren't qualified to answer. When I was given oral glucocorticoids (prednisone) I was gradually tapered off of them I'm sure for similar reasons. With an injection, you don't have this capability so I'm not sure.

 

[CarbsRok]

Hi
My names Alan and I have had the worst 2 days of my life since getting a steroid injection yesterday my glucose levels
are in excess of 33.3 most of the night and I cant contain them any lower than 23.5.
Called NHS 24 who sent me to the local A&E where a Young Doctor told me to stop reacting to my high counts by injecting extra insulin over and beyond my pump as this would be causing me to hypo in my sleep, taking no notice to the fact that I have not slept at all last night being up every hour try to bring my levels down.
thought I had it on the run today until tea time when I started rising from 23.2 to 30.6 so looks like another sleepless night.
I have only eaten 2 meals in the last 36 hours.
Any help will be greatly appreciated.

Hi Alan,
you will probably need to increase your insulin for about 10 days with a gradual reduction. I seem to remember having to double my basal and correct as well as different carb ratios. Whilst on excessive insulin always make sure you have some fast acting carbs handy just in case you have a very sudden drop in blood sugars.
The injection you had works out to be about 100mg of pred in total.

 

[alannemo56]

Hi and thanks for your advice had another bad night and day today I will certainly give this a try and see if I can get things back into order, it's the first time in 28 years I've suffered a problem like this and being so new on pump therapy hasn't helped so onve again thank you for your advice

 

[Gaz-M]

sometimes when been on steriods for chest infections I have had to increase my insulin doses by double some times triple when on mdi just to keep them in the low double figures, I know being on the pump will be different next time I have to go on them, I can't say that would benefit you as it is a personal choice to handle them that way and do not know how long the steriod injection in your system will be acctive for.

I hope you get the levels down to a level where even if high they are not so high as they are now ............

 

[Oldvatr]

A friend of mine is a T1D on a pump, and he gets v high bgl when his cannula gets blocked or drops out or is mis-sited. This may not apply to your setup, but this is a problem he has had a few times now. It happened tonight when I was with him. His bgl went up to 25 in just over an hour. He sorted his cannula out, and could feel the pump working again. His pump gives no warning if there is no flow.

 

[alannemo56]

A friend of mine is a T1D on a pump, and he gets v high bgl when his cannula gets blocked or drops out or is mis-sited. This may not apply to your setup, but this is a problem he has had a few times now. It happened tonight when I was with him. His bgl went up to 25 in just over an hour. He sorted his cannula out, and could feel the pump working again. His pump gives no warning if there is no flow.

Hi thanks for your reply it's more than the site got app with pump therapy nurse today thanks again for your reply it's much appreciated

 

[CarbsRok]

Hi and thanks for your advice had another bad night and day today I will certainly give this a try and see if I can get things back into order, it's the first time in 28 years I've suffered a problem like this and being so new on pump therapy hasn't helped so onve again thank you for your advice

Hi Alan, another thought for you if you have been injecting via syringe to help bring your numbers down then do remember to disconnect your pump and also pump through the same amount of insulin as a correction dose thus the pump is then using the info to calculate corrections and is fully aware then of insulin on board.
I fully sympathise with you as remember the fun (not) when I needed a steroid injection into a joint after tearing the shoulder badly at work one day.

As you are also new to pumping have you invested in the book pumping insulin by John Walsh (Amazon)

 

[LucySW]

Good luck. Just keep an eye on those ketones.

 

[bilb_baggins]

Hi i have been on a pump for 8 years i have had the same problem as you check canula site and try it somewhere else also i have given a injection manualy to bring blood glucose down just keep an eye on your ketones hope this is helpfull .

 

[CarbsRok]

Hi i have been on a pump for 8 years i have had the same problem as you check canula site and try it somewhere else also i have given a injection manualy to bring blood glucose down just keep an eye on your ketones hope this is helpfull .

Alan has recently started on the pump so his basals would not be correct to start with plus the steroid injection equals a recipe for disaster. He just needs a lot of insulin until his sugars come down again. Hopefully his numbers are on the way down by now.

 

[andi140373]

Hi Alan

I'm on a pump and needed steroids to develop baby's lungs early to prepare for delivery at 34wks. They told me to keep doing tests and increase basal by 10% each time I had a reading over 8mmol. It has such an impact on blood sugars that they would only give me the steroid if I stayed in hospital for 2 days. By the evening after the first steroid injection I was on 220% and my ratio for dinner had gone from 4:1 to 9:1. The effect wore off on day 4 and I was back to what had become my normal ratios for late pregnancy.
Because I was needing so much insulin, I was told to change my cannula site twice daily over the four day period to help absorption. When I put the new cannula in, I had to leave the old one in for a few hours to prevent the insulin leaking out from the 'hole' as so much would pool there.
I see this post is a few days old so hopefully things are already better

 

[chrischef]

Hi
My names Alan and I have had the worst 2 days of my life since getting a steroid injection yesterday my glucose levels
are in excess of 33.3 most of the night and I cant contain them any lower than 23.5.
Called NHS 24 who sent me to the local A&E where a Young Doctor told me to stop reacting to my high counts by injecting extra insulin over and beyond my pump as this would be causing me to hypo in my sleep, taking no notice to the fact that I have not slept at all last night being up every hour try to bring my levels down.
thought I had it on the run today until tea time when I started rising from 23.2 to 30.6 so looks like another sleepless night.
I have only eaten 2 meals in the last 36 hours.
Any help will be greatly appreciated.

I had a steroid inj for frozen shoulder and my glucose jumped up to 23, took a week to get back to normal, apparantly streroids do raise blood glucose levels. hope that helps,

 

[chrischef]

I had a steroid inj for frozen shoulder and my glucose jumped up to 23, took a week to get back to normal, apparantly streroids do raise blood glucose levels. hope that helps,