Hi. Your condition sounds complex. Steroids definitely make diabetes worse so bear that in mind. Your bowel problems could be the Metformin or could be caused by many other things such as IBS etc. In my opinion you need to have sugar readings in the high 20s to visit A&E as there is a risk of ketones if you are also low-carbing. Get some Ketostix to check if you are worried. The hospital can only bring the sugars down with insulin so bear that in mind. Much better to keep the carbs low, low-GI and spread evenly thru the day. If you HBa1C remains too high then more meds will be needed. As you are suffering high sugar swings down into hypos it is always possible you have one of the rarer forms of diabetes, but I suspect if you smooth your carb intake the swings will reduce. These are merely my thoughts not as an expert