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I am having constant highs after an allergy/steroids and I think I am having a breakdown over it

C

Catsymoo

Well-Known Member
Messages
301
Location
Portsmouth, United Kingdom
Type of diabetes
Type 1
Treatment type
Insulin
Dislikes
Having diabetes
Hi everybody. I called my diabetes clinic earlier about this, because it has been ridiculous and I am not eating anything out of the ordinary despite it being the holidays. They haven't answered me yet so I am posting here. I'm 27, female, and I'm type 1. On Novorapid/Lantus. Around 26 units of Lantus once a day at 7pm, and Novo for meals but I need quite large doses. Probably 2-3 units per 10g of carbs. Last week/the weekend before Xmas, I had some really weird itchy, nasty rash over my entire body, I felt like **** and my throat was feeling strange. I've had this reaction before to antibiotics, but I am not on any. I had a hair dye patch test and assumed it was just an allergy. On Tuesday the (20th? I think), I was put on Prednisone 30mg/6 tablets for 5 days. I took 4 days worth and refused my last dose because my rash cleared up, and it was making my blood sugars ridiculous as steroids do. I had no appetite, was very angry and crazy so I didn't want to take my last dose.

So this means for 6 days I have been OFF of this medicine. However, my blood sugars are going insane. I never EVER see them in the 20s and I am seeing them in low 20s/high teens after small meals and taking double my insulin + correction doses. This morning I took 16 units of Novorapid. I had a pack of sushi containing 36g of carbs, and a few slices of frozen banana. For this I usually only need 10 units or so and have no problems. I test my sugar an hour later and I'm at 22. This has happened pretty much every single day since I started those steroids. They come down to normal levels at night time, it just seems to be when I eat, it's like the Novo isn't working properly. Online it says 20 hours for Prednisone to leave your system and sugars should return to normal. I have tried changing my insulin vial, injection sites and nothing. I've taken a correction dose of 21 units, and it's only dropped to 19 since then. I don't know what is going on with me, only that I am EXTREMELY stressed and been feeling quite down. But I have never had problems with high blood sugars before, with me it is usually hypos. Is this normal for steroids? It's making me think I might actually be sick instead of an allergy, and I just don't realise it. It's hard to tell because I feel so awful because of the hypers and keep crying, etc. It's scaring me. Sorry for long post, I am just really freaking out over this.
 
The stress could be playing a huge part, I had about 36 hours where my bloods wouldn't come down from my metre saying 'hi'. I spoke to a dsn and he advised changing my vial as a process of elimination.


I'd try and get an emergency appointment with your dsn, if not your gp.

I hope you get sorted asap.
 
Definitely call your clinic back if they don't call you soon.

Did you have a definite diagnosis for the rash or is it possible you have some kind of infection? It might be worth speaking to your GP too.

You probably know this, but if your blood sugar is above 13, you need higher correction doses as your body becomes more resistant to the insulin.

I second the above statement about stress. That can have a huge effect too, so could be exacerbating the situation.

Have you tried very carefully increasing your ratios if it only happens when you eat? I would also stick to 'safe' meals - meals you can carb count accurately, that aren't very high carb, and that you know work for you normally.

But really, you need advice about the possible cause of this, and help getting back control. Do you have ketones?
 
Have you actually increased your basal?
 
Your uncontrollable BG may be related to the rashes you've had. We often need more insulin when unwell. For the last two days I've had a bad cold/virus and have more or less doubled my typical basal dose even though I've seen a huge reduction in daily carb intake due to lost appetite.

FYI, before substantially increasing my basal dose - I was finding that large bolus corrections were having very little impact. My BG would start to drop but then increase before getting near my target value. I've never been as unwell (since being diabetic) to notice how much of an impact that illness has on BG. Now I know that my basal has to be substantially increased when I'm unwell.
 
My rash is gone so I don't think I am sick. I had the rash for about 5 days before I actually went to the doctor, had no issues with blood sugars until I took the steroids. Steroids are notorious for raising blood sugars/insulin resistance/liver glucose but it is weird to still be having this 6 days after I have stopped the steroids. I don't have any ketone strips right now. My current sugar is 9.8, that's after no food and 21 units of Novorapid at 3pm. I'm gonna eat eggs and not much carbs until I can get it sorted. When I saw my doctor about the rash, she was quite baffled and I am actually really ****** off with her for not even telling me the side effects of the steroids. She just said I might get restless and hungry, completely failed to mention the massive effects on glucose levels. These particular steroids are SO bad on glucose, they have been known to give some people type 2 diabetes or pre-diabetes where they raise the sugars so much, especially on high and long term doses. My doctor said nothing about it!
 
When I was on steroids I had to quadruple my basal dose and went down to pretty much a 1:1 ratio for my bolus insulin. Bad form of the doctor not to tell you this, would be a good idea to lodge a complaint as this is a serious side effect.
Keep checking for ketones and remember that very high blood glucose like this makes you much more insulin resistant
 
Steroids will elevate BGLs. Mine tripled for 2 weeks following 3 cortisone injections (in left foot) early December. This was mentioned in the clinic printed information but did not say how high. Back to normal now.
 
I am fairly sure I have seen that many steroids will raise you BG.
Talk to your DSN since you may need to raise your basal and possibly adjust your I:C ratios while you are on the steroids.

Make sure to keep a note of what you are on right now so that it is less guess work when you come off them.

Good luck and try just take it one reading/correction at a time. It may help you to cope with it.

/A
 
Hi again guys, I increased my basal last night from 26 to 30. Then 31 today. Doing it slowly. I noticed last night my sugars were perfect (around 5-6, I even had to have some lemonade and chocolate so I wouldn't drop too low) although I only had an omelette for dinner. This morning we are back up to 10 without any food. I've had a bit of a breakdown and had to quit my job due to bullying, I've been crying all day so it isn't helping. I've had 13 units of Novorapid for 2 profiteroles.. up to 12 now. They aren't really high in sugar and I barely needed any insulin for them in the past. It seems the Lantus is working but the Novo isn't. It's weird. I got a call back from the DSN and she said steroids can ''take a couple of days'' but it's been a whole week. I will call her again on Tuesday if there is no improvement.

I feel a lot more at comfort now someone said 2 weeks of bad sugars after steroids.
 
AndyS said:
I am fairly sure I have seen that many steroids will raise you BG.
Talk to your DSN since you may need to raise your basal and possibly adjust your I:C ratios while you are on the steroids.

Make sure to keep a note of what you are on right now so that it is less guess work when you come off them.

Good luck and try just take it one reading/correction at a time. It may help you to cope with it.

/A
Click to expand...

I am off of the steroids. For a week now. I took 6x5mg for 4 days, I stopped them on December 23rd.
 
@Catsymoo This might be completely irrelevant if the steroids are the cause, but there have been some reports a while ago about a few batches of Novorapid not being effective.

Would it be worth getting a totally fresh batch of it just to see if that helps at all?
 
azure said:
@Catsymoo This might be completely irrelevant if the steroids are the cause, but there have been some reports a while ago about a few batches of Novorapid not being effective.

Would it be worth getting a totally fresh batch of it just to see if that helps at all?
Click to expand...


I was thinking that. It's a bit problematic over the weekend. It's definitely not working. I've had about 35 units of it in the last few hours and I'm still at 12. Had eggs for tea again just to play it safe. I've taken some more basal to try and get it down. The vial I changed to yesterday was from an entirely new pack. I'm starting to get worried.
 
Catsymoo said:
I was thinking that. It's a bit problematic over the weekend. It's definitely not working. I've had about 35 units of it in the last few hours and I'm still at 12. Had eggs for tea again just to play it safe. I've taken some more basal to try and get it down. The vial I changed to yesterday was from an entirely new pack. I'm starting to get worried.
Click to expand...

You could try your normal pharmacy and tell them you believe there may be an issue with the insulin and ask that they replace it maybe?

Or give your surgery or 111 a call. It must be horrible fighting highs all the time.
 
Update: My blood sugars/insulin resistance is still the same. I just have a better handle on it. Carb ratio is probably about 1:2 now compared to 1:7. I took 40 units of Novorapid this afternoon just for 2 pancakes. Sugars are 5.1 now. Really scared I'm gonna pile on weight from all the insulin. My friend is a nurse and said steroids can mess up your sugars for a month+!!
 
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