Acute Steroids.

[SacrificedSin87]

Hi, I’m just looking for a more experienced hand on this one.

Basically, I’ve been struggling with a chest infection which has been making my asthma really play up. Saw a doctor yesterday who said to increase my steroids from my usual 20mg to 40mg for a week. I was told that I could increase my background insulin (abasagalar) from 34 to up to 40 units a day. Problem is, I have had my blood sugars shoot right up and I’m struggling to keep them as they should be? Doctor says that unless I have high ketones then it shouldn’t be too much harm but my average today has been 14mmol. My ketones have been lower than 0.5 on testing.

Does anyone else have any experience about this? Last thing I want is my asthma to keep making me ill but I’m worried about my diabetes being out of control? I’m still new to a lot of this and often feels like I’m spinning plates and one keeps wobbling just as I get the others steady.

 

[Proud to be erratic]

Hi, I’m just looking for a more experienced hand on this one.

Basically, I’ve been struggling with a chest infection which has been making my asthma really play up. Saw a doctor yesterday who said to increase my steroids from my usual 20mg to 40mg for a week. I was told that I could increase my background insulin (abasagalar) from 34 to up to 40 units a day. Problem is, I have had my blood sugars shoot right up and I’m struggling to keep them as they should be? Doctor says that unless I have high ketones then it shouldn’t be too much harm but my average today has been 14mmol. My ketones have been lower than 0.5 on testing.

Does anyone else have any experience about this? Last thing I want is my asthma to keep making me ill but I’m worried about my diabetes being out of control? I’m still new to a lot of this and often feels like I’m spinning plates and one keeps wobbling just as I get the others steady.

My recollection of precise figures are now hazy. But while I was receiving chemotherapy I took steroids as part of the overall chemo treatment. These would make me go way above 15 (the ketone checking threshold). During the first round of chemo and under DSN guidance I increased my Nova Rapid a bit and my Levermir basal by 20.%. During the 2nd chemo round I again lifted my basal but also took a lot more NovaRapid correction with each meal, as well as the basal uplift. This process went on for 8 sessions, each time I got a bit more adventurous trying to keep my BG down and without worsening my frequent hypos. All of this was regulated from fp readings only.

2 yrs later, when a hospitalisation sent my BG skywards and then with the benefit of Libre 2, I raised my Tresiba basal a bit and pretty blatantly leant on my NovaRapid for heavy corrections to keep me in Range. I think CGM with the LOW Alert set at or near its upper limit provides a sensible way of managing high BG at such moments, while still keeping one at low risk of going hypo.

 

[Pumper_Sue]

I was always told 2units of insulin to 1mg of pred.

If you are on basal bolus just increase your basal and carb ratio. Obviously keep plenty of glucose handy in case of a hypo but just increase to your numbers come down.
You have a sensor so make good use of it and adjust accordingly.