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Covid, steroids and raising numbers. Help and experience wanted.

HSSS

Expert
Messages
7,675
Location
South of England
Type of diabetes
Type 2
Treatment type
Diet only
So covid finally got me. 2.5 yrs of ultra caution and triple jabbed planning my boosters later this month. If anyone feels the need to debate these choices please scroll on past without comment. I’m not up to it and won’t be polite.

And it brought some mates, flu and supraglottitis. I’m in hospital as a result confirming all my worst covid fears except one - I don’t seem to be dying just feel like it. l’m on dexamethodose, antibiotics, iv fluids and pain relief. Fluids are 4% glucose so could be worse. I’m unable to eat or drink due to exteme throat pain so any bgl levels are well and truly fasted. I’m up from my usual diet only controlled 6’s and into 12’s so far. I know it’s to be expected due to the illness and drugs I need as the bigger priority right now (which are beginning to help thank god). I have never seen levels this high personally and it’s freaking me a bit.

No one here cares about these levels but they are making me feel worse, eyes not focussed as well mostly but also headaches which I’ve not had til now (I’m not dehydrated either thanks to the drips). Hard to separate what all my other woes are being caused by specifically . I’m hoping to be here only another day or two. They say they’ll release me when I can eat, drink and take non iv meds and the steroids usually work quite fast they promise. So I’m not sure how long, what type etc, I’ll be on for now.

my questions (not medical advice but based on your experiences)

1. What do I sensibly expect from the steroids for bgl? Did they keep rising? Level out at some point? When did medics feel a need to intervene on bgl basis alone? How long after stopping did you see a return to your normal? How fast?


2 apart from navigating the carb loaded hospital menu the best I can when I do manage to eat what can I do to help myself? Particularly in regards to covid and steroids recovery of diabetes control. I’m getting a kick start launch back into fasting and keto already. Much overdue after a poor emergence mentally from protective measures being removed from us. I suspect anything physical is off the cards for a while.

I’m having to advocate for myself largely by typing on my iPad as I have little voice at the moment.
 
Would you ask for and try short term in patient insulin in this situation? Why or why not?
 
Hope you continue to improve and get home soon.
If I was in your position I’d want to know the logic behind giving IV glucose when my blood sugars were that high. If they wanted to keep me on IV fluids I’d ask if I could have saline instead? I’d also tell them that my vision etc… was being affected by my high levels and I was sure I’d feel a lot better if my levels were lower.
 
I have no advice as I’ve no experience of what you’re going through, except maybe this - take a step back and look at the bigger picture, you’ve been very ill with multiple conditions, you’re not eating or sleeping, you’re understandably very anxious, you’re on lots of meds some with a reputation for raising blood sugar. A blood sugar of 12 is pretty good going in my eyes and it’s only in the short term, you are getting what you need to make you better, a few days of higher than normal blood sugar may be worth it to get you well enough- you will be able to sort that out soon enough - sending you hugs x
 
I am very sorry that you are so unwell. Steroids are shockers for blood sugar but they are powerfully effective drugs and sometimes nothing else will do as I know from my own experience. It seems to me that hospital doctors treating acute conditions are ruthless when it comes to focus on the most life-threatening problem. They then mop up any unintended consequences of treatment as and when they occur, but maybe not with the same assiduity. It sounds as if that's what's happening here. Acute hospitals are very good at saving life, but anyone with a chronic condition to manage wants to get out of there at the first opportunity, and I hope that you are soon well enough to be back home and once again in control of what you eat.
 
HSSS said:
Would you ask for and try short term in patient insulin in this situation? Why or why not?
Click to expand...
Just remembered when I was in hospital for something I was diagnosed with diabetes at the same time and they had me on a “sliding scale” which is insulin along side the drip, mind you my levels were at lot higher than yours between 28 - 32! So I don’t know if being around 12 will fit the protocol
 
Hello Really sorry to hear you are in hospital with Covid and other complications. I am type 1 however was very ill with Covid, DKA and a chest infection in March. I know from a blood test only a couple of weeks before I was highly positive for antibodies and I had 3 vaccines too. My BG wasn’t in single figures for about 3 weeks so I think 12 is really not too bad considering Covid, steroids and other drug. I do know from my nurse that they are giving insulin on covid wards to patients (even non diabetics) however Covid does do funny things and you may start to have random lows as well as the highs. I can’t imagine they would give you anything but a very low dose of bolus when you are at 12 but if you start going towards 20 then I personally would ask. It took me about 8 weeks to get back on track but my July HbA1c was 54 so I was really pleased with that. Focus on getting better, my guess would be the hospital don’t think 12 is too bad but as you are probably not used to that it’s likely to be adding to the general unwell feeling. Get better soon.
 
I did try. Not at my best for arguing as I can barely speak. Apparently I ”need” glucose as I’m not eating. ‍ . I’m currently getting a litre over about 8hrs Can t do the maths on that right now.

Havent heard anything from drs about glucose levels. I’ve reported to the nurse I’m not thrilled and he reported my concerns to drs but heard nothing back.
 
Guess I’m looking for reassurance it is only likely to be for the short time im on the drugs and not mess me up longer term. I realise I need them right now and am not fighting that. I also realise 12 isn’t super high for some people but it’s pretty shocking to me as I’ve never seen anything like this.
 

HSSS, I'm sorry you're having such a rough time at the moment. It all sounds very unpleasant.

It sounds like you really do need the medications cocktail at the moment, but hopefully you can be weaned off the IV fluids if you are able to at least drink.
Right now, in your shoes, I would be trying to tell myself to forget testing blood sugars. I imagine they're being done for you periodically anyway?

I know from grilling medical researchers about blood glucose management in hospitals, they are very much concerned about hypos than hypers. A bad hypo can be catastrophic quickly, whereas hypers tend to take a very long time to become dangerous.

I feel fairly confident you won't be kept on high dose steroids any longer than is necessary. If your current numbers mean you have one A1c that's higher than usual, so what?

I doubt very much anyone would be interested in offering you insulin with numbers just in double digits/teens - especially if you are not eating. They could consider that a high risk strategy for potential hypos - especially as you have no experience of how sensitive you could be to it.

Try to focus on getting beyond this crisis stage that you are in. You can then pick off any residual issues as you heal and become stringer.
 
So sorry to hear that @HSSS

Wishing you all the very best .

Can't add to what to do re high BG, except agree with many others

Priority is sort the covid and chest infections asap.

We all relegate the flu right now, but it can be deadly, so urgent attention is needed, which is what it seems you are getting.

A phrase I hear is pick a hill to die on ..as in pick your battles wisely , good advice I'd say .

50+ plus years getting sick with T2D. (most likely)
A few days or weeks won't really matter .

My own spell in hospital, Dec showed me they still test BG daily.
And if it's at 10 or just over they were happy, it wasn't until others were getting closer to the 20 marker they became concerned.

So I doubt they would see insulin given at 12, being a sensible option .

And good luck doing the hospital food two step.
Not easy, but sure once you're eating again, you'll find a way around the menu, easy - ish enough .

Remember a lot of the feeding after such a lay up, is to help us regain our strength and enable us to to mobilise & fight off any reoccurrence of illness, etc

Btw way I hear you on the weak tea...once I was able to eat properly, everything tasted wonderful for a while.



As said, get better soon .
Best wishes for a speedy recovery.
 
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Yeah I’ve resigned myself to just doing what I can food wise. I’ve managed to get a carb list and going with the lowest easiest to eat options there are. That’ll have to do for now. Damage limitation but not stress.

I had a rough night coughing and no sleep so pain levels back up and a day 6 lft is still a dayglo line. I’m definitely a lot better than on admission (not in abject agony and at risk of airway collapse for starters) but still so far to go. It’s a bit up and down and hard to anticipate how I’ll feel hour to hour. I have some voice back to so at least I can speak with the staff a bit now making it less lonely. Waiting on drs rounds for the plan update and what tricks I need to perform to be considered safe at home. Support there is theoretically willing but a bit useless in reality. It’s kind of hitting me emotionally this morning. Obviously need a cuppa and a morning nap.
 
@HSSS I am so sorry to hear you are so sick.

On the steroid front............they work really really well on me, but I react even with small amounts and my BG levels go up really high easily. And it's a very stubborn high that doesn't want to come down. It might last 3-7 days after stopping.... but I know on some people it has lasted weeks.

High blood sugars will also make you moodier, so many hugs your way and I hope for a speedy recovery for you.
 
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Steroids throw my blood sugars into the 20-30’s so I think you’re doing well on that front. On the upside they’re very good at reducing inflammation, on me anyway so I’d go with the current regime and hope you start feeling better soon xx
 
I’m being let out .

Still feeling awful but have past the danger stage thank god. And not a moment too soon. Had a bad night emotionally with it all and need to be home.

Switching to liquid prednisone to tail off the dexamethasone steroids and crushable antibiotic to finish the course. I’m so glad to be getting off iv’s. I’ve had 11 cannulas since Sunday, 6 of which never made it as far as a line as they blew instantly only 3 lasted more than a couple of hours. I have some very colourful forearms- looks like a tatt sleeve.

I’ll be able to choose some food that won’t raise bgl any further too as that’s probably not helping my mood. And I’m sent shopping list ahead of me for my men to panic about before I get there tonight and I won’t be listening to any complaints. They got out of nursing me all week, time to step up the other way round for now. Life skills - even if I have to provide lists to make it work for me
 
I’m so glad you’re on the mend, had me quite worried there for a while you know, being at home once you’re out of danger is the best medicine, now remember to relax and let your men take care of you, it’s amazing what they can do when they have to step up to the plate. If they don’t do it quite like you would then let it go, as long as the end result is the same don’t sweat the small stuff! Wishing you a speedy recovery x
 
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