Hi all
I don't come on to forums much so I am new to this but been diabetic for 8 years. My last hba1c was 7.2, could be better, could be worse. I feel I have reasonable control and I could achieve better levels if I put my mind to it.
However all that has been changed by cancer. I am staggered by how little information there is, on websites but also from professionals. By far the best info I have gained is from other patients but it has been difficult to find. So I have decided to start a new thread with what I have found out as well as my unanswered questions... Hopefully I will get some answer and others in the future facing the same can find out lots from this thread.
One of the major anti-sickness weapons an oncologist uses is steroids. I am on Dexamethasone. My diabetes nurse suggested I bump up my long acting (Lantus) from my usual 18 to 22, to counteract the steroids. Not even close. My first 'normal' blood sugar reading came when I had 48 units of Lantus in my system and overnight had 2 lots of 8 units of novo rapid to correct high readings (or as my meter put it, 'HI' - not even the meter was going to have a stab at a number). The steroids are decreased gradually, so I can't even base the next day on the previous days readings. As I discovered when I spent the next evening setting my alarm every 4 hours to wake my husband to wake me to quaff lucozade and ginger biscuits (ginger eases nausea). Diabetics advise I go on the pump but my DCN is adamant that it would be too complicated. I cannot see how a system I can switch off can be any more complicated than one where an overdose can be massive.
I have also had conflicting info from 2 DCNs, one saying the high sugars are not a risk of Ketoacidosis, the other says it is. To me, this is the difference between asking my oncologist to review the steroids, or just riding it out as best I can. The other is the length of time it takes the steroids to get out of your system - between 24 and 48 hours. I still had elevated readings 72 hours later, but that might have been stress! With such daily changes these steroids bring, I feel like my choice is to deal with hypo or hyper, because anything in between is luck. During the day I opt for hypo, with aggressive corrections (though even these often turn out insufficient) but at night that idea scares me! So I end up with an uncomfortable broken sleep through high levels.
But in fact the most disturbing thing I have come across does not affect me, it affects type 2 diabetes.... With an alarming number of people diagnosed after chemo. With all that pressure on glucose resulting from steroids, the connection seems entirely logical to me, yet oncologists are seemingly unaware.
So that's my diatribe out the way. If anyone has tips, similar experiences or questions I would be extremely grateful of your response. In my little world of the twin evils of type 1 and chemo I have come across but two other people. I am hoping that if there are more, we can pool our experiences and help ourselves and others get through it.
That is all. Good night.
I don't come on to forums much so I am new to this but been diabetic for 8 years. My last hba1c was 7.2, could be better, could be worse. I feel I have reasonable control and I could achieve better levels if I put my mind to it.
However all that has been changed by cancer. I am staggered by how little information there is, on websites but also from professionals. By far the best info I have gained is from other patients but it has been difficult to find. So I have decided to start a new thread with what I have found out as well as my unanswered questions... Hopefully I will get some answer and others in the future facing the same can find out lots from this thread.
One of the major anti-sickness weapons an oncologist uses is steroids. I am on Dexamethasone. My diabetes nurse suggested I bump up my long acting (Lantus) from my usual 18 to 22, to counteract the steroids. Not even close. My first 'normal' blood sugar reading came when I had 48 units of Lantus in my system and overnight had 2 lots of 8 units of novo rapid to correct high readings (or as my meter put it, 'HI' - not even the meter was going to have a stab at a number). The steroids are decreased gradually, so I can't even base the next day on the previous days readings. As I discovered when I spent the next evening setting my alarm every 4 hours to wake my husband to wake me to quaff lucozade and ginger biscuits (ginger eases nausea). Diabetics advise I go on the pump but my DCN is adamant that it would be too complicated. I cannot see how a system I can switch off can be any more complicated than one where an overdose can be massive.
I have also had conflicting info from 2 DCNs, one saying the high sugars are not a risk of Ketoacidosis, the other says it is. To me, this is the difference between asking my oncologist to review the steroids, or just riding it out as best I can. The other is the length of time it takes the steroids to get out of your system - between 24 and 48 hours. I still had elevated readings 72 hours later, but that might have been stress! With such daily changes these steroids bring, I feel like my choice is to deal with hypo or hyper, because anything in between is luck. During the day I opt for hypo, with aggressive corrections (though even these often turn out insufficient) but at night that idea scares me! So I end up with an uncomfortable broken sleep through high levels.
But in fact the most disturbing thing I have come across does not affect me, it affects type 2 diabetes.... With an alarming number of people diagnosed after chemo. With all that pressure on glucose resulting from steroids, the connection seems entirely logical to me, yet oncologists are seemingly unaware.
So that's my diatribe out the way. If anyone has tips, similar experiences or questions I would be extremely grateful of your response. In my little world of the twin evils of type 1 and chemo I have come across but two other people. I am hoping that if there are more, we can pool our experiences and help ourselves and others get through it.
That is all. Good night.
