I was diagnosed a month ago as a side effect of taking steroids. I inject 26 units of NovoMix before breakfast and 14 before supper. My sugar levels are about 5 before breakfast, 11 before lunch, 13-19 late afternoon and about 2 hours after supper. Any suggestions please how I can avoid the peaks?
Cannot keep sugar levels stable
- Thread starter Emersons
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catapillar
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On a fixed dose of mixed insulin your insulin will only be able to cope with a certain amount of carbs in your meals. Have you been given guidance on what the carb content of your meals should be by whoever prescribed the insulin? It sounds like the insulin isn't coping with the carbs in your breakfast and lunch, so you may need to consider slightly reducing the carb content in those meals - discuss this with your HCP, look at gradually stepping down carbs to a level the insulin can deal with. Don't rush in with eliminating carbs, as that will only cause hypos.
Thank you, I am going to reduce carbs slowly and keep any eye on my sugar levels. I think the carbs in my breakfast and lunch have been too high so I am going to eat alternatives
Cereal and low sugar yogurt for breakfast, sandwich for lunch and meat and vegetables for supper. Low sugar drinks, mixed nuts during the day as a snack
Type 3c, thanks for that info, I will look that up. I have been told it may be temporary and resolve itself after I stop taking the steroids. Very little info given by the hospital.
Bertyboy
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This is interesting. I'm very new to all this - I don't even have a full diagnosis yet, but the DSN I met last Wednesday said she would treat it as type 1 with insulin.
Now, whilst they sent me away with the literature and how to use the basal/bolus pens with dosing numbers, I kind of realised later that I have no idea of what to expect in the pattern or if I should adjust doses.
From my point of view, the good news is that I now remember what feeling human is like, my eyesight has been restored, I'm sleeping through the night for the first time in many months and my BG levels immediately came out of the mid 20s, have never gone back into that range, and I even had my first single-digit reading yesterday!
However, and I appreciate this is only 5 days in, the numbers still seem a bit all over the place. They're usually highest first thing in the morning (13-18), just before I have 10 units of Levemir. The lowest numbers are before my evening meal (7-16). There is a general downward trend though, and I am eating reasonably low GI food, negligible sugar.
I had expected someone from the diabetic clinic to call me to check, at which point I could have asked them, but nothing yet (guess they are quite busy!).
Is the pattern reasonable for a brand new insulin user?
Now, whilst they sent me away with the literature and how to use the basal/bolus pens with dosing numbers, I kind of realised later that I have no idea of what to expect in the pattern or if I should adjust doses.
From my point of view, the good news is that I now remember what feeling human is like, my eyesight has been restored, I'm sleeping through the night for the first time in many months and my BG levels immediately came out of the mid 20s, have never gone back into that range, and I even had my first single-digit reading yesterday!
However, and I appreciate this is only 5 days in, the numbers still seem a bit all over the place. They're usually highest first thing in the morning (13-18), just before I have 10 units of Levemir. The lowest numbers are before my evening meal (7-16). There is a general downward trend though, and I am eating reasonably low GI food, negligible sugar.
I had expected someone from the diabetic clinic to call me to check, at which point I could have asked them, but nothing yet (guess they are quite busy!).
Is the pattern reasonable for a brand new insulin user?
catapillar
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That's incorrect. Type 3c is diabetes caused by chronic pancreatitis or surgical removal of the pancreas, so physical pancreatic damage.
Steroid induced diabetes is type 2.
paulus1
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i stand corrected thank you. i thought it damaged the pancreas. i will need to watch that in my daughter. she is on high dose steroids for her asthma. with my family history of diabetes it does not look good for her.
pleinster
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That is completely incorrect. I have Type 2 diabetes as a result of long term steroid treatment. It was correctly diagnosed as Steroid Induced Diabetes (Type 2). Type 3c diabetes is also known as pancreatogenic diabetes and is caused by inflammation of or partial removal of the pancreas and is an entirely different situation, resulting in eventual loss of ability to produce insulin. many people with increased blood sugars due to short term steroid treatment will have their levels return to normal quite quickly on stopping, others (particularly those on steroid treatment of more than a month or two) may well go on to develop Type 2 as I have. It is definitely not Type 3c!! I hope you don't get too stressed by such confusing information, @Emersons. I'm sure @paulus1 meant well but I would advise you to listen to your doctor or at least to those with steroid induced Type 2 diabetes. Also, I wonder why you are on insulin. I never have been, and manage my blood sugar purely through diet (low carb) since choosing to give up the meds over two years ago. You may well, of course, have different issues to me. The steroid responsible for my diabetes was prednisolone following a kidney transplant. Good luck.
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paulus1
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Thank you pleinster, I am also taking prednisolone following a liver transplant. I will be on them for about 2 months in total, so I will have to wait and see. I apparently also have to be careful as the dose is being reduced, the sugar level will reduce also. It was only 4.0 this morning
pleinster
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Hi. You may be lucky and find that things do go back to a non-diabetic normal after stopping. Fingers crossed. I was diagnosed after about 2 months and my steroid dose was high (probably similar to yours). I am surprised they will only have you on them for a couple of months as I was told I'd be on them for life (or at least for the life of the graft) and liver transplant patients I was in with were told the same. That said, different regions do different things..and I hear some places don't use prednisolone at all now. I was also on anti-rejection drugs (MMF and Prograf or Tacrolimus) which you may well also be on..and I hear some places use only these and no steroids. Depends where we are I guess. Anyway, if you do stay on them longer at all be aware that they will still cause spikes in the blood sugar. I only noticed this by recording meter readings and pills/food ingested. My spikes pushed my levels up as much as double for up to 5 hours or more no matter what I ate. I demanded its reduction. Slowly I got things under control the lower the dose. Reduction was a risk because I had to come of one of my anti-rejection drugs due to a virus. I am now on a very small amount of prednisolone with negligible impact so long as I stick to a low carb diet. I only take one anti-rejection
drug in a small dose so I doubt I will ever be fully rid of the steroid. Anyway, I hope it all works out.
pleinster
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paulus1
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my daughter has to take prednisolone regularly she hates the stuff. she is a fragile asthmatic. i hope it does not mess up her body more than it is. not sure her body could cope with diabetes on top of her other conditions.
I have heard bad things about prednisolone. I have also been told by people who have been taking high doses for a while that physical side effects lessen gradually. I think it is good news that she isn't showing signs of diabetes now as I was diagnosed after taking them for only a few days, a doctor suggested to me that I may have been prediabetic, hence the rapid onset.
Pinkorchid
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My husband was diagnosed with T2 after he had been taking Prednisolone for 2 years for Polymyalgia. His doctor said it was almost 100% sure the steroids had caused the diabetes as he was not typical for it in any other way. I think people that only take short courses of steroids are not at high risk of developing diabetes
pleinster
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There is always a slight risk even then, but only slight. I think, in retrospect, it is best avoided if possible, if there are alternatives and I think some doctors know that. Having discussed it with several professionals, I have no doubt diabetes caused my diabetes. Like your husband, I was in no way typical in relation to Type 2 (though to be fair not everyone who develops it is), being slightly underweight most of my life and having no issues with diet or family history etc. It doesn't surprise me that @Emersons says the doctor suggested he may have been pre-diabetic hence the rapid onset as it is not uncommon for that "excuse/"explanation" to be employed; he/she may even believe it. Every transplant patient I talked with in hospital was warned that this particular drug can result in diabetes..and pre-diabetes has nothing to do with it (it wouldn't help obviously). My renal doctors agreed. The pharmacist agreed. My diabetic consultant agreed. Prednisolone caused my diabetes. It is a possible side effect of the drug and that is why the warning exist. That said, I knew that, and I took the risk willingly and would do it again. Sometimes its a trade off, eh? It does not happen in every case and that allows for this "speculation" that a person who gets it may have been prediabetic (despite no evidence at all). I am not angry about it at all, it helped/helps my transplanted kidney stay healthy. Drugs are drugs. I would add that most people taking it for a short time will most likely have slightly increased BS until they stop..and some won't experience increased BS at all. I hope your husband is on a lower dose now as that will make difference to any spikes he may experience on the drug.
