Type 1 Relvar Ellipta (combined inhaler) affecting blood sugars and basal insulin

[stefficlewis]

Hi there,

I was having some issues with asthma & diabetes at the start of this year. I was at diabetic clinic mid-Feb and was advised to try and find some patterns with my BG as I was spiking high with breakfast, asked to come back 8 weeks later with potential to be switched to Fiasp. I was also advised to switch my sites to my legs, use smaller needles and ensure a 30 min pre-bolus. I did all of these things but not much changed with my daily profile.

After about a week I was suddenly going low every few nights and was reducing my night time Levemir from 13 units to 0 (over the following weeks). I spoke to my nurse 2 weeks and she advised to test my basal as I may need more in the morning as I have none at night. I have been testing when possible and have kept at a steady 9 units of Levemir in the morning.. however I have started having dawn phenomenon at about 4am (assuming my Levemir is running out). I don't think I should increase my Levermir as I am sitting steady through the day and night until 4am?

Today I suddenly realised that my steroid inhaler switched to a new one on the same week as I was at diabetic clinic. I am now taking Relvar Ellipta once a day which explains why I no longer need the night time Levemir.. my question is, has anyone else found that switching to this inhaler has caused blood sugar spiking? Do you take it in the morning or night time with any blood sugar effects?

I plan to phone my nurse this week to discuss maybe switching to a longer acting insulin? Not sure this would even help. Any suggestions?

 

[urbanracer]

Hi there,

I was having some issues with asthma & diabetes at the start of this year. I was at diabetic clinic mid-Feb and was advised to try and find some patterns with my BG as I was spiking high with breakfast, asked to come back 8 weeks later with potential to be switched to Fiasp. I was also advised to switch my sites to my legs, use smaller needles and ensure a 30 min pre-bolus. I did all of these things but not much changed with my daily profile.

After about a week I was suddenly going low every few nights and was reducing my night time Levemir from 13 units to 0 (over the following weeks). I spoke to my nurse 2 weeks and she advised to test my basal as I may need more in the morning as I have none at night. I have been testing when possible and have kept at a steady 9 units of Levemir in the morning.. however I have started having dawn phenomenon at about 4am (assuming my Levemir is running out). I don't think I should increase my Levermir as I am sitting steady through the day and night until 4am?

Today I suddenly realised that my steroid inhaler switched to a new one on the same week as I was at diabetic clinic. I am now taking Relvar Ellipta once a day which explains why I no longer need the night time Levemir.. my question is, has anyone else found that switching to this inhaler has caused blood sugar spiking? Do you take it in the morning or night time with any blood sugar effects?

I plan to phone my nurse this week to discuss maybe switching to a longer acting insulin? Not sure this would even help. Any suggestions?

Exactly what you're doing is not really clear to me but Levemir only lasts about 18 hours in the body, forget what it says on the packet. Most users including myself, split the dose. I take 50% at 7am and the remainder at 7pm - or thereabouts.

Although I have a mild asthmatic condition I do not use inhalers as they just don't do anything for me, I have tried most asthma med's over the years without any real signs of improvement. But steroids are known to increase blood glucose levels and although I think that inhalers have a very low steroidal dose - it may be affecting you.

 

[stefficlewis]

Exactly what you're doing is not really clear to me but Levemir only lasts about 18 hours in the body, forget what it says on the packet. Most users including myself, split the dose. I take 50% at 7am and the remainder at 7pm - or thereabouts.

Although I have a mild asthmatic condition I do not use inhalers as they just don't do anything for me, I have tried most asthma med's over the years without any real signs of improvement. But steroids are known to increase blood glucose levels and although I think that inhalers have a very low steroidal dose - it may be affecting you.

Thank you. Yes I was also on a split dose of Levemir (13 at night, 9 in the morning). My need for it at night just completely disappeared. I was thinking If I did some basal testing I would perhaps find that I could reduce the morning dose and increase the nighttime dose again slightly (to stop the 4am rising) but I’ve not found this and it has just stayed the same.

 

[buckmr2]

Hi
I didnt realise Relvar did this and havent noticed it spiking my BG.
I am also on Fiasp , Levemir and Relvar.
The Levemir I take twice per day at 7am and delay the evening dose of Levemir until 9.30pm which stops my blood sugar spiking as much before I get up in the morning.
I find having rhe Levemir earlier eg 7pm and my BG rise more quickly before I get up