How do you keep your sugars down on steroids?

[sp00kysk311y]

I’ve had steroids twice now due to my first chest infection not going away properly, then coming back twice as hard this time.
I am now on antibiotics, steroids and an inhaler.

I am on a pump, and my DSN helped me set up another profile for whilst I was on the steroids but it doesn’t seem to be working this time around, for whatever reason as they are the same steroids I was on before and for the same amount of time.

I have no idea what else to do. I’ve tried drinking water, I’m barely eating hecause I don’t have an appetite right now whether that be the chest infection or my bowel condition (EPI). What else can I do to bring my sugars down? Corrections aren’t doing a of either. I’ve Been up most nights correcting them every 20-30 minutes (to give it time to lower before another correction).

 

[Lucyr]

Sounds like you need to make changes to the steroids profile you have set up if you’re always high and corrections aren’t helping?

 

[Inka]

@sp00kysk311y If your blood sugar is high, you’ll need more insulin for corrections. You shouldn’t be correcting every 20-30 mins, as with high sugars it can be two or three hours before you see your sugars start to move.

Have you put on a temp basal rate increase? Are you sure your insulin is ok and not degraded? Are you sure your site is working?

 

[sp00kysk311y]

Sounds like you need to make changes to the steroids profile you have set up if you’re always high and corrections aren’t helping?

Unfortunately it’s a Saturday and I can’t get in touch with my DSN who decides what goes onto that profile. I don’t do it myself.

 

[sp00kysk311y]

@sp00kysk311y If your blood sugar is high, you’ll need more insulin for corrections. You shouldn’t be correcting every 20-30 mins, as with high sugars it can be two or three hours before you see your sugars start to move.

Have you put on a temp basal rate increase? Are you sure your insulin is ok and not degraded? Are you sure your site is working?

My site is working as it goes down, eventually, but then it goes up again. Steroids always do this to me. It done it to me last year when I was on them again for the same reason.

 

[Inka]

My site is working as it goes down, eventually, but then it goes up again. Steroids always do this to me. It done it to me last year when I was on them again for the same reason.

Have you tried a temporary basal rate? You could try one for a short duration then assess how much it helped.

 

[sp00kysk311y]

Have you tried a temporary basal rate? You could try one for a short duration then assess how much it helped.

I’m not sure how to do this? I usually speak to my DSN but as it’s the weekend, I can’t contact her as she won’t be in the clinic obviously. The soonest I would be able to contact her, would be Monday.

 

[Inka]

It varies slightly on each pump @sp00kysk311y I have a Dana i pump but I think you have a T Slim? Temporary basal rates are used to reduce or increase basal for a short period of time. For example, someone might want to reduce their basal rate if they were going on a long walk. If their blood sugar was running a bit high due to illness, they might want to do a temporary increase of basal rate. On my pump, you can do it for as little as one hour or up to 12hrs (I think). I tend to use short periods of temporary basal rates, so I can see how things are going.

@everydayupsanddowns uses the T Slim but if you’re uncertain, maybe you should stick to corrections but just space them out more. Then you can speak to your DSN on Monday.

 

[Lucyr]

Unfortunately it’s a Saturday and I can’t get in touch with my DSN who decides what goes onto that profile. I don’t do it myself.

Most people adjust their insulin doses themselves, can your DSN show you how to adjust it yourself next time you speak to them?

 

[everydayupsanddowns]

Sorry to hear the steroids are messing your levels around, and that the profile that worked last time isn’t working so well this time around

I get that will periods of illness too, where what worked last time isn’t necessarily right this time around, so it’s nothing you are doing wrong, it just seems to be part of the game of living with T1 🙄

Do you use sensors with your tSlim, and Control IQ?



You can’t run Temp Rates if Control IQ is active, but if it’s switched off, you’ll find Temp Rate under the Activity menu.

You set a time duration (eg 1 or 2 hours) and then choose a value above 100% if you need more insulin and below 100% if you need less insulin. How much adjustment you need will be very individual, so no one here can really offer a suggestion. Some will see a big effect from a small change, others will need to run a much higher TBR for longer to see any difference at all.

So you might start cautiously with 120% for 2 hours and see if it helps?

It generally takes at least 30mins or an hour for a temp rate to start having any effect at all.

 

[SB2015]

I have always been surprised by how much extra insulin I need after a steroid injection. I use a closed loop system which is fine for ‘normal life’ but I have had to go into manual mode to get enough insulin in to deal with steroids.

When I follow the sick day rules I test every two hours and then do another correction. Once my levels come down below 14 I switch to every four hours.

It would be well worth you talking to your DSN about using a temporary basal rate for these circumstances. With illness this can help as our needs are higher and resistance to insulin higher. When in manual mode on my pump, like you I had an illness profile but this needed changing using temporary basal rates as well depending on how ill, how much pain I was in.

Let us know how you get on.