Corticosteroids and controlling blood sugar

[Kimbag73]

Hi
I have started a short course of steroids for acute asthma for the second time in 6 weeks and they have a horrendous impact on my sugars. I have increased my Levemir by 50% for each dose at the moment (last time in Dec I only did half that and it wasn't enough) but I wondered if anyone else had experience of this and any advice.

 

[CarbsRok]

Hi Kim, yes steroids do have that affect on blood sugars. You need to increase both basal and bolus when on steroids. For me it works out to about 2 units for every 1mg of prednisolone. Do make sure that you have plenty of glucose handy whilst increasing your dosage though just in case you have a very sudden drop once your steroids are reduced again with insulin levels.

 

[Kimbag73]

Thanks. I'm on 40mg for 5 days so pretty sure I don't need that much. My usual combined insulin dose is about 50units a day so have increased at the moment from 27 basal to 40 basal and seems to be ok. I guess because I'm sick as well, hence the need for steroids I have to monitor closely and am just correcting with boils as necessary. Good to hear from someone else though

 

[wiser]

Hi

Hope this is all relevant. About 2 weeks ago I was put on a very high dose of dexamethasone which did indeed play havoc with the sugars. The advice i was given was based on prednisolone.

I was told to expect a peak around 2pm (taking it at about 8.30). This did indeed happen. I was on a much higher dose but I had to increase my basal far more than I would have expected. I think that the advice to keep checking is wise. I did roughly every 2 hours but it helped that I was admitted to hospital.

By the looks of it you should be nearly at the end of the course but hopefully you have managed it. I had the dex because it was only a 4 day course and I could cope for that short time. The alternative was 6 months on prednisolone.

Hope you getting better.

 

[mrspuddleduck]

Hi Kim, yes steroids do have that affect on blood sugars. You need to increase both basal and bolus when on steroids. For me it works out to about 2 units for every 1mg of prednisolone. Do make sure that you have plenty of glucose handy whilst increasing your dosage though just in case you have a very sudden drop once your steroids are reduced again with insulin levels.

Really good advice @CarbsRok , I'm just trying (again) to come off Pred, I know its different cos I'm a long term steroid patient but this week has been the hell of sudden and severe hypos! Carry glucose when you do come off them, better to be safe than sorry! Xx

 

[Notorious]

Hello. When I took them I had to roughly quadruple my boluses and the same with basal. It was for a problem with my feet and legs which also made exercising difficult. (I am type 1 so don't usually have significant insulin resistance and I'm a regular runner.)
More worryingly, for a while I completely lost hypo warning symptoms, so I would confirm the advice to check blood glucose often.