Steroids and Insulin

[Poodlelady]

Hi,
I am relatively new to diabetes, being diagnosed in March of this year and crashing into keytonacidosis (sp). I am in my 60's and was diagnosed with type 1 diabetes and put onto Novomix 30. Everything was going so well until I was diagnosed with Polymyalgia Rheumatica and put onto steroids. Now my glucose levels are out of the window so to speak. They are almost hypo in the morning and up to 12 or 13mmol at tea time.

I have incresed my morning dose of insulin, then I found I had to be very careful I did not go hypo at midday. I am really at sea with it all now.

I wonder if anyone else has been put onto long term steroids and how the glucose levels were brought back to single figures? Please help, I am really quite upset by it all and cannot get hold of my Nurse at the diabetic clinic.

 

[noblehead]

Steroids can play havoc with diabetes control, I suggest you keep trying to get in touch with your DSN and ask for advice about adjusting your insulin doses.

 

[daisy1]

Hi Poodlelady and welcome to the forum I don't know if this information will help you since your problems appear to be caused by steroids but this advice may be useful and interesting to you anyway. In spite of your problems maybe this will give you some help with your BG levels. This is the advice we give to new members. If you have any other questions please do not hesitate to ask as there is always someone here to help. In the meantime I hope someone here can help you with your problems while you are trying to get hold of your recalcitrant nurse.

BASIC INFORMATION FOR NEWLY DIAGNOSED DIABETICS

Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you’ll find well over 30,000 people who are demonstrating this.

On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

The role of carbohydrate

Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

The bad news

Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

The good news

People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

Controlling your carbs

The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.
There are two approaches to controlling your carbs:

• Reduce your carbohydrate intake
• Choose ‘better’ carbohydrates

Reduce your carbohydrates
A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

Choosing better carbohydrates

Another option is to replace ‘white carbohydrates’ (such as white bread, white rice, white flour etc) with whole grain varieties. The idea behind having whole grain varieties is that the carbohydrates get broken down slower than the white varieties –and these are said to have a lower glycaemic index.
http://www.diabetes.co.uk/food/diabetes ... rains.html

The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

Read more on carbohydrates and diabetes

Eating what works for you

Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

The blood sugar ranges recommended by NICE are as follows:

Blood glucose ranges for type 2 diabetes

• Before meals: 4 to 7 mmol/l
• 2 hours after meals: under 8.5 mmol/l

Blood glucose ranges for type 1 diabetes (adults)

• Before meals: 4 to 7 mmol/l
• 2 hours after meals: under 9 mmol/l

Blood glucose ranges for type 1 diabetes (children)

• Before meals: 4 to 8 mmol/l
• 2 hours after meals: under 10 mmol/l

However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

Access to blood glucose test strips
The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:

• structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
• self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education

Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to blood glucose testing supplies.

You may also be interested to read questions to ask at a diabetic clinic

Note: This post has been edited from Sue/Ken's post to include up to date information.

 

[KazV1]

What steroids are you on exactly?

 

[Poodlelady]

What steroids are you on exactly?

I am on Prednisolone and recently the dose was doubled to 20mg daily. The pain from the Polymyalgia has eased slightly, but I am finding it difficult to walk any distance or do anything like grooming my Poodles as the pain and weakness soon comes back again.

I have increased my morning insulin and decreased the evening insulin. I have to be very careful and make sure that I eat by 12noon every day or I could go hypo, yet in the afternoon when the steroids seem to kick in my sugar levels soar. I have played around with food, I was told that one tea cake is better than two slices of bread. So I tried this and my sugar levels soared. I then went onto a very low carb diet and my sugar levels in the afternoon soared. Yet, after a good supper and before bed time I do a bt and I can be too low to go to bed on the result. I have to have a small bowl of breakfast cereal to carry me through the night or my sugar levels drop drastically by 3am.

It has been a nightmare, but I think I am getting on top of things now. I don't worry about the afternoon levels as by supper time they are now usually down to a nice single figure just below or on 10. In the morning I am down to 5.4mmol which does not suit me at all. I make sure I have cereal and some fruit, banana or apricot with my cereal and that carries me through to noon.

I think this site is great, such helpful adivice and it does make me feel I am not alone. Thank you all.