Steroid Induced Diabetes

[All at sea]

Hello I wondered if anyone could offer advice?
My uni student son has been diagnosed with an autoimmune condition at Easter. He's been very poorly and in hospital twice and has been treated with IV steroids and then oral prednisolone on a reducing dose (now 30mg). On Tuesday he had a random blood sugar test of 18.5 and has been given Gliclazide 80mg morning and 40mg evening. Diabetes nurse checked in on Friday and all was well.
Pre lunch yesterday his blood sugar was 2.9 without any symptoms of a hypo. Pre evening meal 10.9. Overnight he has had a severe headache and blood sugar 3.5 this morning.
We don't know what to do as have no contact details for the diabetic team who are calling him tomorrow. My feeling is to leave out the 40mg evening dose but perhaps ringing 111 is a better option? Any words of wisdom would be very kindly received.
Thank you

 

[Inka]

Welcome @All at sea Sorry to hear about your son’s problems. The severe headache could well be a hypo headache. It seems he’s also going low before lunch.

Did he receive any guidance about his diet? With Gliclazide you need to eat an appropriate amount of carbs at each meal and keep to that amount each day. Did he eat anything different when he had the hypos? Is he finger-pricking to test or does he have a Libre?

I think you should phone 111. In general, the advice is to avoid hypos as much as possibly. Because of his steroids, they can give him appropriate advice.

 

[janw]

Hello and welcome @All at sea
I take steroids every so often, the exact ones your son is on, 5mg per tablet, 6 tablets per day - so yes the 30mg. I was given them in A&E late last night and did not bother to check my BG this morning as steroids put it way high. The other morning it was 10.4 whereas "normally" I am around 5 - 6, so you can see how high it can raise it. IV steroids do the same, my steroid inhaler (just one puff usually) also raises my BG a little, so I only test before I use it.
Please make sure these tablets are taken with or after food - I made that error a couple of weeks back, got a pounding headache, felt really out of sorts and was even a bit sick. Last night I made sure to get some bread and butter from a nurse before I would take my 6 steroid pills, no side effects then.
Yes they do cause "false high" readings. Medical staff ought to know how steroids affect the BG and take that into account - I think you need to be very vocal about reminding them of the medication he is receiving. I take no meds at all, diet control only, but I would personally be very concerned if they tried giving me meds whilst on steroids - I think that could be asking for trouble and I would advise that you seek medical advice at once regarding Gliclazide. It is always best to err on the side of caution.
ETA - I did check my BG this morning, it was 15.3 - yesterday it was 6.1 without any steroids.

 

[All at sea]

Thank you for your comments we have called 111 and awaiting a call back.

 

[TheClockworkDodo]

I hope you got some help @All at sea

Just a word of caution about calling 111 - the medical professionals you speak to will not be diabetes specialists or autoimmine specialists, so they will not necessarily give appropriate advice (I found this out the hard way soon after I was diagnosed). As Jan says it is always best to err on the side of caution, so if your son continues to have hypos it might be safer to get him to A&E and ask for him to see a diabetes specialist.

Assuming all is well tonight, when you speak to the diabetes team, do ask for their contact details and ask who you or he should call if he needs specialist help or advice out of hours again.

 

[everydayupsanddowns]

Sorry to hear what a difficult time your lad has been having @All at sea Lurching from high to hypo like that is exhausting, and can make you feel pretty grim

Steroids can be a swine for messing with BG levels.

Hope NHS111 were able to help, and that you didn't have @TheClockworkDodo ’s tricky experience!