Asthma

[LooperCat]

So at the ripe old age of 43, I’ve been diagnosed with “allergy induced asthma” today and given a brown steroid (beclometasone) inhaler. I’ve had a blue Ventolin one for a year or so, in case I accidentally ingest some of the foods I’m allergic to, but I’ve been needing to use it several times in the night over the last few months even though I’ve been super careful about the allergens. Came to a head last night when I almost passed out through not being able to breathe properly.

My question for the hive mind is this - is a low dose steroid inhaler (2 puffs of Qvar 50 twice a day) likely to cause a problem with my blood sugars? Do any of you have a problem with them? Would basal or bolus insulin be the best one to look at adjusting first?

Thanks in advance for any advice, I thought it was just a chest infection, so this has come as a bit of an unpleasant surprise.

 

[Alison54321]

I have asthma, but I've had it so long, and taken the beclo..........brown inhaler (I can't spell it) for so long I can't remember how it affected my blood sugar, though with te assistance of a nurse, I reduced the dose a lot a couple of years ago, and added a salmeterol inhaler instead, to reduce use of the salbutamol.

If I remember correctly using the salbutamol inhaler tended to push my blood sugar up a bit, so getting things better controlled with the preventer might be useful. It might push your blood sugar up a bit, but my instinct would be to increase the basal, because it's role is as a long acting preventer.

My asthma these days tends to be triggered by the wrong sort of chemical, I bought some very cheap paint brushes, and that turned out to be a problem. I kept googling to find out if anyone else had this problem, because it seemed so strange, but I never got anywhere, so I had to use a process of deduction instead.

Hopefully the brown inhaler will work, but if you're still needing to use the ventolin a lot, I'd go back, asthma can be very nasty, if it's not controlled properly.

 

[Pipp]

So at the ripe old age of 43, I’ve been diagnosed with “allergy induced asthma” today and given a brown steroid (beclometasone) inhaler. I’ve had a blue Ventolin one for a year or so, in case I accidentally ingest some of the foods I’m allergic to, but I’ve been needing to use it several times in the night over the last few months even though I’ve been super careful about the allergens. Came to a head last night when I almost passed out through not being able to breathe properly.

My question for the hive mind is this - is a low dose steroid inhaler (2 puffs of Qvar 50 twice a day) likely to cause a problem with my blood sugars? Do any of you have a problem with them? Would basal or bolus insulin be the best one to look at adjusting first?

Thanks in advance for any advice, I thought it was just a chest infection, so this has come as a bit of an unpleasant surprise.

@Mel dCP
I was a similar age when diagnosed with allergy asthma, some 20ish years ago. Sorry you are having a worrying time. The 'not being able to breathe properly' is panic inducing in the extreme.
I have preventer inhaler to use morning and night, which is steroid based. I also have the reliever to use as necessary. I was scared about the steroid one at first, but find that it appears to have no discernable effect on blood glucose levels, and it works very well in keeping airways open. I tend to just need the reliever if I have a cough or cold, or if I push myself too hard exercising and get wheezy. Always keep a couple of relievers ready, in bag, car, around the house and definitely with sport bag.

One thing that was helpful for me at the start was allergy testing, because my breathing was not improving with the first inhalers prescribed. I was found to be allergic to the propellent gas in the aerosol type inhalers, and when they were changed to dry powder had no further difficulty with them. Hope you have been given some itesting and identified triggers.

Sometimes if I get a chest infection I have to have steroid tablets. These do cause temporary BG increase for a few weeks, but is the lesser of two evils, and so far I have still managed to keep BG below diabetes diagnostic levels.

One piece of unsolicited advice, I hope you will forgive me for, is that during an asthma attack when struggling to breathe, it helps me to believe I can. Not always easy as first instinct is panic, but that just sends my lungs into a spasm that is difficult to stop. So the trick I use is to first tell myself to stop fighting, then convince myself, calmly, to take small gentle breaths rather than big gasps of air. Hope this has been some use and you feel better soon.

 

[LooperCat]

Thank you both for such informative replies, that’s some really useful information. Ventolin/salbutamol doesn’t seem to affect my BG, I can track that on my Libre, so luckily if the the brown one does, I’ll be able to spot it quickly and react accordingly.

I have had extensive allergy testing in the last few months, at the immunology department of University Hospital Wales because my food allergies are so unusual. I’m horribly allergic to mammal and bird meats, cow dairy, and oilseedrape pollen, as well as hair dye! Most of those I’ve learned to avoid, but still get caught out occasionally. It’s surprising where you find meat and dairy...

And thanks for the panic advice, @Pipp - I’ve trained myself not to panic if I hypo, so I expect with some practice I can nail that too. Perhaps with some breathing exercises that my close friend, a yoga teacher, uses for her own asthma.

 

[Pipp]

Sorry to be so personal, @Mel dCP , and don't feel you have to answer if you don't want to, but have your immunology team tested your blood tryptase levels? They can be key to working out a treatment plan for unusual allergic type reactions.

 

[LooperCat]

Sorry to be so personal, @Mel dCP , and don't feel you have to answer if you don't want to, but have your immunology team tested your blood tryptase levels? They can be key to working out a treatment plan for unusual allergic type reactions.

I’m not sure which enzymes they tested other than IgG responses to various foods, tbh. They did say that it was so unusual to be allergic to meat that little research had been done into treatment for it and that the only thing I could do was to just not eat the things I reacted to.

 

[LooperCat]

Hmmm. Not sure if this high day is due to the new inhaler or what. I’ll watch for a few days to see, before making any adjustments to my Tresiba basal, and just correct with Novorapid but

 

[Alison54321]

When you had your not being able to breathe at night experience, were you given anything else by the doctor? Even if you weren't, asthma can do crazy things to adrenal function, so this might be a reaction to the previous night's asthma problem, rather than the inhaler.

When I had my paint brush problem my first indicator of a problem was a too high blood sugar. So it might be the aftermath of that.

 

[LooperCat]

No, just the brown steroid inhaler. I’ve had similar nights (although not quite so bad) that haven’t affected my levels like this. Anyway, last night was quite calm on the breathing front, and these were today’s readings. Could just be one of those lovely T1 unpredictabilities, so I’ll leep watching!