Antihistamines & steroids

[UserABC2021]

I have been pondering why my BG climbs nearly 2 points an hour or so after waking, especially this week as I've been fasting and the pattern continued.

The answer may lie in my non-diabetes medication. I take fenofexadine to counter my allergies (which can be severe), but I also take a steroid combination inhaler (Symbicort) for my COPD. I only take these when waking, and through the day my BG drops quickly below 6 and is stable.

I searched on the effects of both drugs and whilst I couldn't find any damning evidence for the antihistamine, there was sufficient evidence for the inhalers effect on the liver.

Will do a test tomorrow and not take them until after breakfast.

 

[LooperCat]

Sounds very much like “dawn phenomenon”, where your liver dumps glucose and cortisol into your system to get you ready for the day. Everyone gets it, non-diabetics’ pancreases kick in to deal with the glucose, type ones tend to take a “foot on the floor” dose of insulin to bring it down - I’m not sure how type twos manage it, but there’s bound to be one along shortly who can help. I doubt it’s your meds.

I get woken by it every morning between 4 and 7, and take a unit or two of insulin depending on my levels. It’s a tricky one to deal with, for any and all diabetics...

 

[Bluetit1802]

Steroids can play havoc with blood sugar levels. That is well known, and there is such a thing as "steroid-induced diabetes".
However, It is more likely to be the liver dump (dawn phenomenon), which can actually be worse when fasting for several days.
Hormones kick in just before or just after we get up telling our livers to dump glucose into the blood stream for extra energy. In normal healthy non-diabetics the pancreas secretes insulin and this clears the dumped glucose into the cells and tells the liver to stop dumping. In insulin resistant T2s the secreted insulin can't do its job properly as the cells have become resistant to it, so the glucose stays in the blood stream and the liver continues to dump.

Many people have tried many things to stop it, but nothing really works well. A coffee with double cream as soon as you get up seems to work to an extent, or some fatty protein such as cheese or eggs. (Not carbs).

It all goes away when insulin resistance goes away.

 

[UserABC2021]

Steroids can play havoc with blood sugar levels. That is well known, and there is such a thing as "steroid-induced diabetes".
However, It is more likely to be the liver dump (dawn phenomenon), which can actually be worse when fasting for several days.
Hormones kick in just before or just after we get up telling our livers to dump glucose into the blood stream for extra energy. In normal healthy non-diabetics the pancreas secretes insulin and this clears the dumped glucose into the cells and tells the liver to stop dumping. In insulin resistant T2s the secreted insulin can't do its job properly as the cells have become resistant to it, so the glucose stays in the blood stream and the liver continues to dump.

Many people have tried many things to stop it, but nothing really works well. A coffee with double cream as soon as you get up seems to work to an extent, or some fatty protein such as cheese or eggs. (Not carbs).

It all goes away when insulin resistance goes away.

It's all a lot more complicated than it first appears, so many angles, I can see I'm going to need a deeper understanding of the insulin cycle.

 

[Pipp]

The liver dump / dawn phenomenon goes into overdrive for me when I have had steroid meds for allergies too. For several weeks after I have fasting levels of 8 - 9. Tests throughout the day are higher than usual too. In the past the levels have settled after about 3-4 weeks. More recently it is taking longer for BG to return to my usual levels. It is a worry, but sometimes managing my other health conditions have to take priority over my diabetes. I have to use steroid inhalers every day as a preventative measure. I only find the raised BG levels when taking oral steroid medications, which I have needed more frequently in the last year or so. The steroid inhalers don't appear to have a negative effect, though it is difficult to tell.

 

[UserABC2021]

but sometimes managing my other health conditions have to take priority over my diabetes.

Indeed, and this is my concern as I'm managing lung volume by exercise and diabetes by diet. At the moment my steroid intake is quite low, however, chest infections can change that by an order of magnitude. Thank you for your insight.

 

[Pipp]

Indeed, and this is my concern as I'm managing lung volume by exercise and diabetes by diet. At the moment my steroid intake is quite low, however, chest infections can change that by an order of magnitude. Thank you for your insight.

I gain insight from experiences of others, too. So thank you for yours.
In the past few years I have been able to exercise more frequently than of late. Getting the balance right can be quite difficult when allergies are affecting breathing so badly. Perhaps a solution for me will be to increase the exercise when I am well enough. Avoiding people with coughs and colds is imortant, too. It is a fine balancing act.