'Fast' treatment for Hyperglycaemia?

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Meady

Meady

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Type 2
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Evening all,

I suffer with hyperglycaemia when I have to take steroids (prednisolone) normally 40mg a day used to combat issues with my asthma. I'd asked my GP how high is high, when I should ask for help and was advised anything over 20mmoL/l and that I should consult NHS 111. Well I hit 20.8 so filled out the online form which gives you the following choices:

LEvels.jpg

No problem, they did phone back around 3am and I finally had a clinician call just now but missed it as my phone automatically blocked the call as it though it was spam. The message left was that they were going to close the case. Ok, fair enough but, in am still in hyper land. Therefore, my question is this;

As a Type 2 on insulin (Humulin), metformin and dapagliflozin if, my sugar levels are high as advised by my GP, is there a short term 'fix' to bring down levels quickly (I don't think there is)? Or what should I be doing? The current medication works fine and generally keeps things in order but the steroids create mischief.
 
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What Humulin do you have @Meady ? There are different types. Look for letters and/or numbers after the word Humulin.
 
The quickest solution would be a fast-acting insulin but I suspect your Humulin isn’t that type. As you’re on steroids, perhaps you could ask your doctor about having one for emergencies if your blood sugar goes very high?
 
Without a fast-acting insulin, you could very cautiously reduce the carbs in your meal slightly, but do be cautious as you don’t want to risk a hypo. If your blood sugar remains over 20 for any length of time, I’d give 111 another call @Meady
 
Meady said:
Evening all,

I suffer with hyperglycaemia when I have to take steroids (prednisolone) normally 40mg a day used to combat issues with my asthma. I'd asked my GP how high is high, when I should ask for help and was advised anything over 20mmoL/l and that I should consult NHS 111. Well I hit 20.8 so filled out the online form which gives you the following choices:

View attachment 29398

No problem, they did phone back around 3am and I finally had a clinician call just now but missed it as my phone automatically blocked the call as it though it was spam. The message left was that they were going to close the case. Ok, fair enough but, in am still in hyper land. Therefore, my question is this;

As a Type 2 on insulin (Humulin), metformin and dapagliflozin if, my sugar levels are high as advised by my GP, is there a short term 'fix' to bring down levels quickly (I don't think there is)? Or what should I be doing? The current medication works fine and generally keeps things in order but the steroids create mischief.
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Hello, are you using a sensor? (If so which type.) or just a meter? Also can you test for ketones?
My suggestion may sound old hat. Steady walk a few blocks could help.
But as mentioned above. A correction dose of a faster acting insulin is the usual course of action with BGs this high.
 
@Inka just tested, currently at 17 mmoL/l
Inka said:
Without a fast-acting insulin, you could very cautiously reduce the carbs in your meal slightly, but do be cautious as you don’t want to risk a hypo. If your blood sugar remains over 20 for any length of time, I’d give 111 another call @Meady
Click to expand...
 
Meady said:
@Inka just tested, currently at 17 mmoL/l
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That’s better 🙂 It’s still higher than ideal but that’s a safer high. If you can manage to keep things there or lower, you should be ok. Ideally you’d be under 15, but if you’re 17 then that’s alright.
 
Hi Meady
Any steroid will prompt your liver to chuck out glucose, I had a similarly experience when taking Dexamethasone during chemotherapy.
Treatments choices are : increase exercise, reduce carbohydrates or use short/ quicker acting insulin. Perhaps you could ask your prescriber to prescribe a short acting insulin if you are prescribed steroids for asthma flare ups. You are used to injecting insulin and have a monitoring device so should be safe.
Typically my insulin usage doubled when on a single dose of steroids, much trickier if you are taking prednisolone for several days as I suspect you are.
Good luck, Chris
 
Meady said:
As a Type 2 on insulin (Humulin), metformin and dapagliflozin if, my sugar levels are high as advised by my GP, is there a short term 'fix' to bring down levels quickly (I don't think there is)?
Click to expand...
Go for a walk, or go up and down the stairs, and drink enough water. Exercise will make you more sensitive to insulin so your background insulin may drop you a bit if you increase exercise. Or get extra medication like a rapid insulin for when on steroids if it’s a regular thing.
 
How steady are your increased levels when you are on the steroids @Meady ?

Do your levels stay consistently high all day? Or do they rise and fall, but rise to much higher than you are used to?
 
Chris88 said:
Hi Meady
Any steroid will prompt your liver to chuck out glucose, I had a similarly experience when taking Dexamethasone during chemotherapy.
Treatments choices are : increase exercise, reduce carbohydrates or use short/ quicker acting insulin. Perhaps you could ask your prescriber to prescribe a short acting insulin if you are prescribed steroids for asthma flare ups. You are used to injecting insulin and have a monitoring device so should be safe.
Typically my insulin usage doubled when on a single dose of steroids, much trickier if you are taking prednisolone for several days as I suspect you are.
Good luck, Chris
Click to expand...
Yeah, I'd heard about steroids affecting glucose levels. Found that out about 4 weeks ago, I was hospitalised with asthma and hyperglycaemia. Long storey, had a cold, prescribed steroids and antibiotics due to the Asthma, on day 2 of steroids consumption everything went south, both lungs rattling like a train and glucose levels went through the roof off the scales was told I'd managed to hit 30mmoL/l. To be fair, I don't remember much that day.

I getvreal thirsty with T2 but thiscwas nextvleve, I've never experienced such an insatiable thirst! Anyway, now I've experienced the steriod induced hyper! Glamileride stopped and humulin I started.

Will ask about the short/ quick acting to see if that will help and yeah, generally 3-4 days of steroids up to 40mg a day.
 
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Lucyr said:
Go for a walk, or go up and down the stairs, and drink enough water. Exercise will make you more sensitive to insulin so your background insulin may drop you a bit if you increase exercise. Or get extra medication like a rapid insulin for when on steroids if it’s a regular thing.
Click to expand...
Thanks for the tips on exercise and drinking enough water and exercise. This is a relatively new experience for me so will try everything and see what works best. Am arranging a review with my asthma and diabetes nurse on the quick acting insulin and steroids.
 
everydayupsanddowns said:
How steady are your increased levels when you are on the steroids @Meady ?

Do your levels stay consistently high all day? Or do they rise and fall, but rise to much higher than you are used to?
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Under normal circumstances, they rise and fall during the day but generally stay within range. However todays has been like:

03.13 - 14.8
07.15 - 12.4
13.41 - 12.4
18.11 - 17.0
22.01 - 14.7

I did add a few more units this morning and this evening injections.
 
Satan’s little helper said:
Hello, are you using a sensor? (If so which type.) or just a meter? Also can you test for ketones?
My suggestion may sound old hat. Steady walk a few blocks could help.
But as mentioned above. A correction dose of a faster acting insulin is the usual course of action with BGs this high.
Click to expand...
Just a meter, have an accu-chek thing, am not able to check for ketones but will ask my diabetes nurse on that one if I can get a tester. Seems like it's the more obvious choice on fast acting insulin so will find out on that one if they will prescribe it.
 
This is just a nightmare, one more day of steroids to go, still in hyper land and just tested at 23.9 mmoL/l. Falling asleep while doing stuff.

Waiting on a call back from 111 now. Steroids are mischief!
 
Hopefully they’ll give you some fast-acting insulin to get it down @Meady If they do, see if they can prescribe you some to take away with you in case you need it again.
 
Meady said:
Now in A&E with a glucose reading of 28 mmol/L. All OK but feeling rather rough. Be interesting to see how this is combated
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Depends who you get. One time I was there with high bg and high ketones in urine they just tested blood ketones and sent me on my way as not in DKA. Another time they gave a litre of fluid and sent on my way. I wouldn’t expect much more than telling you to make an appointment with the diabetes nurse unless you’re actually in DKA really.
 
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