Shingles and post herpetic neuralgia

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Val14

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Type 1.5 LADA
Hallo just looking for some advice.
Diagnosed as Type 2 Diabetic 2018
But then diagnosed as Type 1.5 LADA in April 2020 following hospital visit with DNK
l got shingles over a week ago got severe pain first so I thought I had pulled a muscle but a rash came on the Friday but I managed to get anti viral drugs from the walk in centre on the Saturday

But the pain has been relentless more persistent at night and no amount of painkillpers would shift it so rang Doctors this Friday and have been given Pregablin for post herpetic neuralgia. However the pain continues not all the time but when it is there it is so painful. Also my blood glucose level seem to be running high and I keep adding a correction dose to keep them in check.
I am just wondering if anybody has experience of this and am I expecting too much of the Pregablin (only been taking them since Friday night) I had hoped pain would stop or at least reduce but didn’t sleep Friday or Saturday night . I will contact Diabetic nurse Monday to check what I should be doing about insulin I think I may need to double my dose ( I don’t take a lot 2 ml at Breakfast 3ml at Dinner and 10 ml at night for the 24hours).
Anybody had experience of this or can give suggestions or advise would be very welcome.
ValR.




y b
 
Have you tried speaking with the DiabetesUK helpline to see what they can suggest?
 
Hi @Val14 Sorry you’re in pain. It must be hard and I believe pain after shingles can be quite unpleasant.

What insulins do you take? You’re taking 2 units of fast acting, then 3 units, and 10 units of basal - is that right? What are the names of your insulins? When did you start taking insulin? Apart from your pain, it’s possible your insulin needs have simply increased over time as your remaining beta cells failed. If you can tell us a little more, you’ll get suggestions that might help with your highs. Do you carb count and adjust your mealtime insulin? How high are your sugars?
 
Coincidentally, I was diagnosed with shingles yesterday.
Thankfully, my pain is manageable with off the shelf painkillers (I am alternating ibruprofen and paracetamol).
However, I have noticed than the pain is a great hypo/hyper indicator. If your blood sugar levels are running high (which is not at all unusual when our body is fighting off a virus and our livers are dumping extra glucose to help). This could be making your pain worse.

i recommend getting in touch with your diabetes team/dsn for assistance if your high levels persist.
In the meantime, this recent post about sick day rules may help https://forum.diabetes.org.uk/boards/threads/sick-day-rules.85644
 
Inka said:
Hi @Val14 Sorry you’re in pain. It must be hard and I believe pain after shingles can be quite unpleasant.

What insulins do you take? You’re taking 2 units of fast acting, then 3 units, and 10 units of basal - is that right? What are the names of your insulins? When did you start taking insulin? Apart from your pain, it’s possible your insulin needs have simply increased over time as your remaining beta cells failed. If you can tell us a little more, you’ll get suggestions that might help with your highs. Do you carb count and adjust your mealtime insulin? How high are your sugars?
Click to expand...
Hi Inka
Thank you for your response.
l take Fiasp fast acting at breakfast and dinner and then take 10 of Lantus at night. I started taking insulin in May 2020 when I was 65 and diagnosed as Type 1.5 diabetic. I don’t carb count, I have tried my husband tends to cook and getting him to weigh the carbs is just too difficult I have tried to take over the cooking but we are probably just set in our ways. My blood sugars are probably not that high when compared with some but they are high for me they have gone up as high as 14.6. I have spoken to the Diabetic nurse this morning and she said what I had been doing which was increasing my Fiasp to 3 in the morning and 4 in the evening and then doing a correction of 0.5 if sugars continued to increase. So feeling a bit better about the insulin dosage but still worried about the post hepatic neuralgia as it seems this can possibly take weeks months or even years to clear.
 
helli said:
Coincidentally, I was diagnosed with shingles yesterday.
Thankfully, my pain is manageable with off the shelf painkillers (I am alternating ibruprofen and paracetamol).
However, I have noticed than the pain is a great hypo/hyper indicator. If your blood sugar levels are running high (which is not at all unusual when our body is fighting off a virus and our livers are dumping extra glucose to help). This could be making your pain worse.

i recommend getting in touch with your diabetes team/dsn for assistance if your high levels persist.
In the meantime, this recent post about sick day rules may help https://forum.diabetes.org.uk/boards/threads/sick-day-rules.85644
Click to expand...
Thanks Helli for your response.
I was able to speak to the Diabetic nurse today so have been given some guidance on increasing my insulin. Unfortunately for me ibuprofen and paracetamol was just not doing anything for my nerve pain , it is truly horrendously painful. The Pregabalin is now starting to help and the pain is more a dull ache most of the time just the early hours of the morning when it seems to kick in again.
 
Val14 said:
Hi Inka
Thank you for your response.
l take Fiasp fast acting at breakfast and dinner and then take 10 of Lantus at night. I started taking insulin in May 2020 when I was 65 and diagnosed as Type 1.5 diabetic. I don’t carb count, I have tried my husband tends to cook and getting him to weigh the carbs is just too difficult I have tried to take over the cooking but we are probably just set in our ways. My blood sugars are probably not that high when compared with some but they are high for me they have gone up as high as 14.6. I have spoken to the Diabetic nurse this morning and she said what I had been doing which was increasing my Fiasp to 3 in the morning and 4 in the evening and then doing a correction of 0.5 if sugars continued to increase. So feeling a bit better about the insulin dosage but still worried about the post hepatic neuralgia as it seems this can possibly take weeks months or even years to clear.
Click to expand...

I understand the difficulty you have regarding carb counting. You could still try a basic version of it maybe - not weighing, noting thing by eye and then jotting them down. For example, say you had pork chop, cabbage and boiled potatoes, you could make sure you had the same amount of potatoes each time (eg 3 egg-sized ones or whatever), note your Fiasp dose and if it worked ok. If not, when you have the same meal again, adjust your Fiasp dose slightly and cautiously, and see how that goes. If it works - ie you’re in range 2hrs after your meal - then you can jot that meal down in your notebook along with the Fiasp dose.

You can do that for lots of meals, using your eye or serving spoons or tablespoons to measure rice or pasta. That way you’ll gradually know what dose works for each meal.

Sorry I can’t help much with your pain, but I’d give it a few days and if there’s no improvement perhaps your dose could be increased or another medication tried.
 
Val14 said:
Hallo just looking for some advice.
Diagnosed as Type 2 Diabetic 2018
But then diagnosed as Type 1.5 LADA in April 2020 following hospital visit with DNK
l got shingles over a week ago got severe pain first so I thought I had pulled a muscle but a rash came on the Friday but I managed to get anti viral drugs from the walk in centre on the Saturday

But the pain has been relentless more persistent at night and no amount of painkillpers would shift it so rang Doctors this Friday and have been given Pregablin for post herpetic neuralgia. However the pain continues not all the time but when it is there it is so painful. Also my blood glucose level seem to be running high and I keep adding a correction dose to keep them in check.
I am just wondering if anybody has experience of this and am I expecting too much of the Pregablin (only been taking them since Friday night) I had hoped pain would stop or at least reduce but didn’t sleep Friday or Saturday night . I will contact Diabetic nurse Monday to check what I should be doing about insulin I think I may need to double my dose ( I don’t take a lot 2 ml at Breakfast 3ml at Dinner and 10 ml at night for the 24hours).
Anybody had experience of this or can give suggestions or advise would be very welcome.
ValR.




y b
Click to expand...

Val, I won't comment on your insulin issues, as you seem to have had some help in that regard.

I've had shingles twice; both times at the top of my face, into the hairline, but involving an eye. The pain was "interesting" to say the least.

I was advised it can take a long time to go, and mine did, although over time it tapered off to become more of a nuisance than anything else. I was overjoyed the day I realised I hadn't felt like someone was stabbing my eye for a whole day!

I was advised to manage the pain, as exhaustion wasn't the way to heal. Thankfully I managed without anything heavyweight as you have.
 
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