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Struggling with side effects, T2 and steroids

Unicorn69

Newbie
Messages
3
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Hi all, I have recently been put on a massive dose of steroids which has totally screwed with my diet controlled T2. I’m now taking rybelsus and glyclazide to control the high blood levels but struggling with serious side effects, struggling to eat, sleeping all day and night and generally no energy for anything.
Has anyone had similar or can offer some advice I’d be very grateful.

Thanks
 
Test your ketones levels. As you might need to go hospital to bring down your high glucose and high ketones going on IV and insulin treatments.

I'm Type 2 Diabetes currently on prednisolone - Day 2 (for asthma trigger due to bush fire smoke in the air yesterday) - I have got high glucose and got moderate ketones levels. I'm in early risk for DKA. (Diabetes Ketoacidosis)

Only medication I take is Ozempic.

I'm drinking water which is slowly bringing down my glucose from 20 mmol to 14.5 mmol, ketones levels is still moderate atm.
 
The simplest way to think about the effect of strong steroids is to look at the dawn phenomenon that we all know and love...

So - that is caused by the release of Cortisol at the start of the day - ok - so far so non-controversial. But - what is Cortsisol, why, it's a naturally produced cortico-steroid, which is why when you are injected with a large dose of external cortico-steroids (all steroids which are not anabolic steroids are cortico-steroids) it has exactly the same effect as Cortisol, and your blood glucose shoots up.

As your blood glucose goes up - like any time this happens - your blood insulin will go up (with the usual caveats about meds and a functioning pancreas) - and when insulin goes up, ketone production will drop.

However - I'm not trying to contradict @Kiwigal - be aware of the symptoms of DKA and do measure your ketones if you can - Gliclazide will affect insulin so it's a possibility, but DKA is a state of out-of-control ketone production alongside high blood glucose because you either have no insulin, or you are so insulin resistant that it's having no effect. If your recent control was good, and you are going through a short-term situation because of steroids - you are probably doing the only thing you can, getting a lot of rest and recovering to the point that you can stop the steroids - and regroup.
 
Test your ketones levels. As you might need to go hospital to bring down your high glucose and high ketones going on IV and insulin treatments.

I'm Type 2 Diabetes currently on prednisolone - Day 2 (for asthma trigger due to bush fire smoke in the air yesterday) - I have got high glucose and got moderate ketones levels. I'm in early risk for DKA. (Diabetes Ketoacidosis)

Only medication I take is Ozempic.

I'm drinking water which is slowly bringing down my glucose from 20 mmol to 14.5 mmol, ketones levels is still moderate atm.
Thanks for the advice. I have no way to test ketones and not been given any information on these.
Im on week 2 of 60mg prednisilone and have been hoping the side effects would have worn off but unfortunately trying to get thr blood sugar levels right is proving a task but I keep trying. Thankfully I’ve only had one hypo
 
The simplest way to think about the effect of strong steroids is to look at the dawn phenomenon that we all know and love...

So - that is caused by the release of Cortisol at the start of the day - ok - so far so non-controversial. But - what is Cortsisol, why, it's a naturally produced cortico-steroid, which is why when you are injected with a large dose of external cortico-steroids (all steroids which are not anabolic steroids are cortico-steroids) it has exactly the same effect as Cortisol, and your blood glucose shoots up.

As your blood glucose goes up - like any time this happens - your blood insulin will go up (with the usual caveats about meds and a functioning pancreas) - and when insulin goes up, ketone production will drop.

However - I'm not trying to contradict @Kiwigal - be aware of the symptoms of DKA and do measure your ketones if you can - Gliclazide will affect insulin so it's a possibility, but DKA is a state of out-of-control ketone production alongside high blood glucose because you either have no insulin, or you are so insulin resistant that it's having no effect. If your recent control was good, and you are going through a short-term situation because of steroids - you are probably doing the only thing you can, getting a lot of rest and recovering to the point that you can stop the steroids - and regroup.
Thanks for the advice. Unfortunately I’m only on week 2 of long term and high use, currently 60mg per day. I’m a bit of a wimp with a morbid fear of being sick so it’s a bit of a challenge. I’m currently negotiating changes to my sight and trying to deal with whether they are permanent
 
How high are your blood sugars @Unicorn69 ?

Here is what the NHS has to say about DKA

 
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