Steroids and Type 1

Were your blood glucose levels running high while you had the infection and were on steroids? Were you taking more insulin to combat this? The reason I'm asking is that both infection and steroids will increase your insulin resistance, and therefore your blood glucose levels. When the infection clears up and you stop the steroids, that resistance goes away, and blood glucose will decrease. If you're still on higher insulin doses (or for example, using lantus, which can take 3 or 4 days for a change in dose to fully take effect), then this can lead to hypos, and then seizures. I'm on long-term steroids for another condition, and I find that if my dose is lowered, then my blood glucose drops and runs much lower for the next couple of days, until my insulin doses have been sorted out.

I've had a couple of seizures, much the same as yours where I had hypo treatment but it had no effect. Pretty **** scary, and I felt like **** for a couple of days after. I hope you're feeling better now.

Hello, my name is Issi and this is the first time I have posted onto this forum, so apologies if I'm not doing it right...!

I just wanted to say a huge thank you to this forum, especially this thread for the help and advice I have read generally, and specifically over the last week.

I've been asthmatic since I was 13, but was diagnosed with Type 1 a couple of years ago when I was 39. Which I've been told several times is quite old. Talk about adding insult to injury!

NYE morning I came down with my first proper chest infection in 5 years. I was taken to A&E by some lovely ambulancemen. The Doctors went through my medical history a few times (noting that this was my first bout of serious asthma in 5 years, AND marvelling at how someone of 'my age' developed Type 1 Diabetes only 2 years ago). They prescribed a week-long course of 40mg prednisolone per day. And didn't mention anything else about the diabetes. The pharmacist confirmed with me that I was taking insulin. And didn't say anything else.

Now this will come as no surprise to most of you, but I was completely shocked by how thirsty, tired, dying for the loo, sick and shaky I was feeling. That's got nothing to do with asthma. But felt a bit like when I was first diagnosed with Type 1 (via a nice dose of ketoacidosis). So measured my blood sugar. My nice posh machine (thanks Ms Diabetes Nurse!) said Hi. I thought it was being polite, but it turned out my sugar was off the charts. I panicked. It was now NYE night and I didn't know what to do. So I turned to this Diabetes forum and entered the search term 'type 1' and 'steroids'. I'm so pleased I did.

Thanks to you and your advice, I managed to bring my sugars down to almost acceptable levels, and keep them down, through a combination of slightly increasing my rapid insulin, then measuring blood sugars, adjusting etc (sometimes every hour). I also increased my basal insulin.

Of course everyone's insulin use is completely personal, unique to them and their situation,it isn't an exact science, and what works for one person could cause all sorts of problems for other people. So I'll just say that in order to keep MY blood sugars down to reasonable levels, I had to use anything between 1.5 to 3 times my usual insulin doses. I'm not even beginning to hint at suggesting that anyone should do the same.

Anyway, I'm now through the worst of the infection, and have come through it a lot better as a result of the discussions on this forum. I will also be extremely careful with deciding on my next basal injection.

Thank you so much for sharing!

Hi issidoyle and welcome to the forum. You definitely should have been warned that steroids raise blood glucose levels as it is well know, in fact Prednisolone is what caused my T2 diabetes although I was on steroids for around 3+ years :crazy:

Steroids should always be stopped slowly never stopped overnight as your adrenal gland gets used to the regular level of steroid so it stops producing its own and if steroid treatment is stopped abruptly there is a risk that your adrenal gland forgets to start production again. I had this problem 4 times which is why I ended up on steroids for so long and I was weaned off them over 4 or 5 months, reducing 10mg a week down to the last 10mg which I continued to take as a maintenance dose for a while before reducing it again by 1mg per week right down to 1/2mg for the last week. Thankfully my adrenal gland restarted its production and took over from the pred.

Sid Bonkers said:

Hi issidoyle and welcome to the forum. You definitely should have been warned that steroids raise blood glucose levels as it is well know, in fact Prednisolone is what caused my T2 diabetes although I was on steroids for around 3+ years :crazy:

Steroids should always be stopped slowly never stopped overnight as your adrenal gland gets used to the regular level of steroid so it stops producing its own and if steroid treatment is stopped abruptly there is a risk that your adrenal gland forgets to start production again. I had this problem 4 times which is why I ended up on steroids for so long and I was weaned off them over 4 or 5 months, reducing 10mg a week down to the last 10mg which I continued to take as a maintenance dose for a while before reducing it again by 1mg per week right down to 1/2mg for the last week. Thankfully my adrenal gland restarted its production and took over from the pred.

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Sid, don't you also get issued with a card to carry around for 12 months after you having finished long-term steroids in case you are admitted to hospital?

Sid Bonkers said:

Hi issidoyle and welcome to the forum. You definitely should have been warned that steroids raise blood glucose levels as it is well know, in fact Prednisolone is what caused my T2 diabetes although I was on steroids for around 3+ years :crazy:

Steroids should always be stopped slowly never stopped overnight as your adrenal gland gets used to the regular level of steroid so it stops producing its own and if steroid treatment is stopped abruptly there is a risk that your adrenal gland forgets to start production again. I had this problem 4 times which is why I ended up on steroids for so long and I was weaned off them over 4 or 5 months, reducing 10mg a week down to the last 10mg which I continued to take as a maintenance dose for a while before reducing it again by 1mg per week right down to 1/2mg for the last week. Thankfully my adrenal gland restarted its production and took over from the pred.

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The stopping steroids gradually only applies to long term use A 4 day course wont cause adrenal gland problems unless you already have an underlying problem not yet discovered.

CarbsRok said:

The stopping steroids gradually only applies to long term use A 4 day course wont cause adrenal gland problems unless you already have an underlying problem not yet discovered.

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Which was exactly what happened to me 4 times ending up with me being intubated for 6 days and a 2 week stay in ICU Each time I came off the prednisolone after just a short course, exactly 3 days later I was having what I believe they wrongly assumed was an asthmatic exacerbation in fact it was coming off steroids and still having pneumonia, not confirmed but thats what I reckon it was as they had to treat it with huge amounts of IV antibiotics while I was on life support.

I dont recommend it and if I have to take prednisolone again I will insist that I am withdrawn slowly as per the instructions of my ICU consultant.