Steroid Induced Diabetes - new to it all

[Abbi]

Hi My mum has just been diagnosed with Type 1 diabetes at the age of 73. She is receiving treatment for rheumatoid arthritis and after taking steroids for 2/3 months had a severe hyper which resulted in being admitted to hospital where they decided she has diabetes. She has insulin (Humalog) morning and night and came home from hospital after a week, yesterday.

It is all very new to us and we are helping her to manage her BG levels. We don't yet know if it wil be permanent as she is being weaned off the steroids but the auto immune disease she has may have also have damaged her pancreas so not sure what the future holds yet. Doctors are trying to juggle all the meds to manage the arthritis and the diabetes.

She has been told to eat fairly "normally" and not to worry how high she goes (was BG 55 on admission!) as the steroids push the levels high. She has had a few lows which she has coped with (lucozade so far has helped).

Any advice from anyone in a similar position would be very much appreciated. We feel a bit out of our depth at the moment but sure it will become clearer as we get more used to managing things with her.

 

[Blythespirit]

Hi Abbi and welcome to the forum. I'm so sorry to hear about your mums diagnosis but you have found the right place for help and support. We have a few members who juggle other things as well as diabetes. I'm sure one of them will be along with some sage advice soon. In the meantime have a browse around and ask about anything that's bothering you. Good luck with everything, and your mum is lucky to have a daughter who's looking out for her. XXXXX

 

[David H]

For about 20 yrs I was recieving Steroid injections twice yearly for very bad allergies.

The steroid injections were discontinued because they were linked to Diabetes and Osteoporosis.

I'm a Coeliac, a type 2 Diabetic and have Osteopenia (a precursor to Osteoporosis)

 

[Copepod]

Abbi welcome to you and your mother. However, it's very unlikely that she has type 1 diabetes, more likely type 2 diabetes treated with insulin. Humalog (which is a short acting insulin) alone is unusual, though. It's more usual to start with either just a long acting insulin (Humalin I has the name nearest to Humalog) or a bimodal insulin (there are examples with Humalin in their names). It's likely she needs high doses of insulin, due to insulin resistance in her all her body cells, one of the effects of long term steroids.
You're right about it being a challenge to manage things, and also right to realise that it can't happen instantly. Probably the key thing is to check and record blood sugar levels so you can help medics to decide on the right insulin regime.

 

[Pumper_Sue]

Hi Abbi,
sorry to hear your Mum has had this extra problem added to her plate.
With prednisolone as a rule of thumb it takes 2 units of insulin to cover 1mg of pred. So this would mean a lot of insulin is needed whilst on a high dose of pred if someone has diabetes. Hopefully your Mum's pancreas will come to life again once the asult on her system has stopped (steroids)
To help your Mum try suggesting cutting down on startchy carbs this will relieve her pancreas no end.

 

[Abbi]

Thank you all for your replies, you have made me feel very welcome and pleased to know that you are all there to advise.

Some Dr's have said type 1 and others have said we don't really give it a type so not really sure!

She is currently have 34 units in the morning and 24 late afternoon and I thought it was Humalog but will check as seems there are different types with similar names!

They are slowly weaning her steriod dose down and is now on 10mg per day.

I did think that we should do several readings a day but she has been told to do them twice a day. To be honest it is so difficult to get any blood out of her finger that it becomes so stressful trying to get a reading. We have the device on No 4 but the prick only results in the tiniest dot of blood that's not enough to get a reading. Can you get bigger needles?

Thank you all once again for your advice.

 

[robert@fm]

I did think that we should do several readings a day but she has been told to do them twice a day. To be honest it is so difficult to get any blood out of her finger that it becomes so stressful trying to get a reading. We have the device on No 4 but the prick only results in the tiniest dot of blood that's not enough to get a reading. Can you get bigger needles?

As far as I know lancets are only made in very fine sizes so as to minimise the pain (just about all manufacturers claim that their system is more pain-free than everyone else's🙄), so no luck there.

There are various techniques to stimulate blood flow and hence make it easier to test; since washing one's hands before the test is a good idea, you could use warm water to dilate the capilliaries and stimulate the flow. Holding the hand to be tested straight down for a few minutes is also said to help. It also helps to "milk" the finger just after pricking to increase the drop size; stroke with firm pressure from the base of the finger towards the puncture (I've found that gently pulling the skin away sideways, to encourage the hole to open, sometimes helps). And finally, remember to use a different site each time, so they get a chance to heal and don't scar; scarring would make getting a sample even harder.

Failing all else, using other sites to test (if your meter and lancing device supports this) may be the answer, but you would have to discuss this with your doctor or DSN first.