Steroids and basal dose

[paulliljeros]

Good evening all,

Having just gone through the fun of a suspected stroke, but getting the relieving news its "only" Bells Palsy, I was sent on my way with a big pile of steroids. I was aware of previous discussions regarding the affect on BG, so duly monitored, and as my sugars went up, so did my basal and corrections.
I increased my pump basal up by +30%. This was ineffective, so today I have increased to +100%, but am still struggling. After a quick search I saw @CarbsRok mention in a post approx 3 years ago that the increase should be approx 3x. Obviously it needs to be done with caution and monitored, but just wondered if anyone with experience of steroids can give their input please? I simply would never have imagined needing to treble my basal. I am also interested whether you increase bolus doses to a similar level?

Thanks in advance, Paul

 

[kitty55]

Hi Paul! I was on steroids for a while due to IVF treatment - it was a fairly low dose at 20mg/day though. I was advised by my DSN to increase my basals by 40%. It wasn't good enough. Over a couple of days where I carefully monitored my sugars I increased all basals by between 60-70%. I increased my bolus too but I'm afraid I can't really tell by how much - it was a bit but probably not 60%.
I hope this helps a bit and I am glad it wasn't a stroke you had!

 

[paulliljeros]

Thanks @kitty55, that does indeed help. So far I am on 50mg pd and am at 200% basal and roughly doubling correction doses as a result of not really increasing bolus much, so I am going to start increasing bolus by about 80-100% as at least with CGM I can react to any over zealous doses I do do! To be honest, it's a helpful indicator that its not just a faulty set or insulin, as despite seeing threads about steroids previously, I was still blaming the pump at first.

 

[kitty55]

@paulliljeros Good luck with adjusting your doses! I was quite surprised how much I eventually had to increase all my insulin - it was a good bit more than I expected. Luckily with a CGM you are able to keep a close eye!