ulcerative colitis And Steroid induced Diabetic.

James Foote

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Steroid Induced Diabetes
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Hello to all,

First an apology I suffer from dyslexia so rely on auto correct and boy has that landed me in hot water a few times.
I think this post is more for me than others reading it, it all started when I was 12 years old and not I am 58 on the 17th September so we will start with day one, joking honest just joking.

Diabetes runs in my family on my mother’s side, it killed her and it will kill my sister. All mums side of the family had it and most abused it with terrible outcomes because of this and knowing I was at risk I had always taken my blood sugar reading over the years, one in the morning just before food and two hours after. I would do this for a few months then leave it for 6 then start again. According to my GP I had never even had a spike don’t get me wrong there is a fat bugger behind this key board and have always been large all my life I part to me eating food that did not hurt my ulcerative Colitis and kept thing flowing at the right consistency though at the time I did not know I had UC because I was 44 before I got my diagnosis.

12th March 2006 is a day that even writing it down has brought a tear to my eye, it was the day my wife of 14 years died of a brain hemorrhage I was 39 years old and the stress of all this caused my colitis to start a new chapter many starting with OMG, ow and far to may expletives for this polite company.
Over the years my life moved on and I re married to the amazing Diane and life was good. On the 18th September 2010 I had my colitis confirmed and because I had constipation as well as diarrhea it was very complicated to keep me on a level but I managed it and kept things on a level and life was good again.
November 2018 took a turn though when I woke feeling very very cold being sick and diarrhea, nothing to do with the colitis, I got up not wanting to wake my wife and went down stairs to ring 111, thank god I did because he pushed me into saying it was heart related even though I did not think it was that. An ambulance arrived very quickly and they seemed a little put out because I had needed am ambulance a few weeks before because I have a very bad neck and take some very serious drugs for it even though I had a very long wait and they though I had pulled a fast one even though it was 111 who called them. Very quickly they realized I was quite unwell just as my poor wife walked in asking what is going on, “sepsis” was the reply I was feeling quite drunk but I was so lucky. I walked to the ambulance but on the way I went into septic shock and collapsed. A two year recover started but the main thing for this story was the colitis had caused it with a new area of the gut being the problem.

Sorry War and Peace length story and I have not even said diabetic yet,
Six months after the sepsis I had a terrible colitis flare with severe consternation. Unfortunately the way colitis is treated is with steroids and steroids causes massive spikes in blood sugars. I was treated 8 days in hospital them 3 months of steroids at home after this I was left with pre diabetes so for the next few years I kept taking blood sugar reading and every visit to the doctor showed them the figures and the response was always very good or nothing scary.
Then February 2024 happened I was feeling quite off my neck was very bad I was at the highest morphine dose and just waiting for my spine injections. I had been up several times over the night to go to the loo. It was dark so no checking until the morning when I checked what was going on and it was just blood OMG so much blood so I rang my colitis nurse but no answer but instructions to call 111 which o did and sent them the photos, ow yes there are photos, at this time the pain was to much and they wanted me to go to A&E I did point out pooing myself in there was just not fair so the nurse did what she needed to do and told me off “ this is a medical emergency but I will make an appointment for you.” Within the hour I was in a bed in the hallway but I was being treated. I told them I was a pre diabetic from my last flare but the treatment for my worst flare ever was steroids and lot off them 250mil per day I just did not stand a chance. 8 days of 250mil and then 40mg reducing at home for 3 months.
I knew something was very very wrong so I took my blood sugar reading follows by NO no no no no 23 no no. Now in my doctors there are leaflets that say go to the best area for help and I was well past ringing for an appointment with the GP for I rang diabetes.org the lady was amazing. James you need to get off this phone and ring your doctors tell them it is an emergency, ow flip, ok I did not say flip and I am not proud of it because there was a lady on the other end of the phone line but in my defence this was a shocker.
Turned out my HbA1c thing was 66 not good. I was put on two 500mg of Metformin and one 5mg Dapagliflozin. My last HbA1c was 39 by the way and I have lost weight.nearly 3 stone.
The biggest problem I had was my neck I can sleep all night all day and all night with the fatigue I have morphine and Diazepam in my pain management. After the injections into my spine I stop all pain meds, assuming I don’t trip or bang my neck, and have stayed on the same dose for many many years. As you can imagine waking up at 3 am with the worst headache and neck pain taking these type of medication and going to bed is not good for keeping an eye on your blood sugar. My wife works from home 2 days a week and so far she had woken my up to test and find my blood sugar was under 4 but this was becoming quite scary. I follows the advice from this site to get a Libre 2 unit but my doctors keeps passing me piller to post. As you can tell I am not very good at writing but my wife is and she sent a letter asking for them to change there mind on the unit but I received no reply apparently if they don’t reply we did not read it.
My doctors , who are fantastic by the way, operate triage system where you can fill your details out online so that’s what I did meaning they’d have to beat it and I added I needed help and I needed this device for my own safety or something very serious could happen I then received my Abbotts Libre 2 unit and boy was this a game changer to my safety. I have learned don’t react to the Libre right away check with a monitor. The worst alarm was 2.2 and I felt terrible struggled to swallow the glucose gel the doctors prescribed I did get in there and though it didn’t get me over four it did push me up to about 3.4 which enabled us to walk back to get to a café a lesson learnt and we now carry more than one item just in case I go low because of my neck, I struggle to walk on any ground as hard and in fact, I’m talking 5 or 6 steps before getting a jolt on the neck but when I’m on grass, I can walk quite a long way. I’m that is what causes a problem with the 2.2 I’m still learning but after the things that have happened I am grateful to be alive so dealing with things like blood sugars slip in the neck and colitis is not that bad

Honest.

I would like to recommend to the forum they add a sleepy go by by section and add this post there.

James
 
That was not the easiest thing I've ever read, James - but I'm at least, pleased for you, that you've got that off your chest and want to send you empathy and - very careful! - Hugs. I've never had to take steroids regularly for anything but my OH does, since he's had COPD for some years now and has to take em plus antibiotics if he ever gets an actual chest infection - and other people will keep breathing out bacteria and since they aren't visible, it's impossible to avoid unless he stops breathing in - which neither of us think is a really good idea :rofl: - but we've both seen him easily gain over half a stone at the end of a course of the buggers.

Life CAN be hard at times it's true - but considering the alternative - let's all just plod on!
 
Welcome to the forum.
You've been through a very rough time there. If you have any questions regarding diabetes please ask away, folks here have a lot of combined experience.
 
Thank you to you both. It was a good vent and something I think I needed to do, fortunately I have always looked on the bright side well you have to or we would all go mad.
To be very honest here when I received my diabetic diagnosis I two ways to look at it. My life has come to an end. Oh no oh I’ve been forced to look after myself. I went for the latter and that’s no bad thing. I’ve lost a lot of weight. I’m feeling good my Colitis is proving to be, a real bugger because all the things that are good for the diabetes are bad for the Colitis and good for the Colitis so bad for the diabetes but I seem at the moment to have happy medium. I must do for my A1c reading to be 39 so I’m doing something right , but I’m not gonna lie the thing that absolutely petrifies me is another severe colitis attack because I don’t know whether that will leave me. The Sun is shining. I’m on holiday and life is good.

James
 
Welcome to the forum @James Foote

Thanks for sharing your story-so-far. Sorry to hear about all the difficulties and troubles you have faced, but glad you have made it through and retained your positive attitude.

Congrats on your great A1c. Particularly having to balance the needs of two such difficult and fickle conditions!
 
Thank you so very much. It is a pain sorry for the pun but boy it is.
I think as long as I can keep my colitis out of a flare I will be ok

I will have to add to the main forum how I ended up getting a Libre 2 with type two even though every one was saying no or that person can do it but no they could not. It has really helped.

One thing I am not use to are the lows when we went on a walk and I had an alarm at 2.2 the glucose gel just did not cut it and it was very scare because I almost fell over a number of times and I am not sure I would of gotten up again. I think a hypo emergency pack may be a good idea. May be a gel and the sugar things but also a drink but all small enough for my wife to carry in her bag

Does anyone have any advice on this.
James
 
These events can be very scary, my other half has had Crohn's for many years but largely asymptomatic with the very occasional flare up, he was taking a medication which seemed to manage it. But he suddenly got a severe attack with a very high heart rate but it did seem very different to the usual. We ended up going to A &E where they said he had a perforated bowel due to appendicitis which given he had his appendix removed some 50 years before but it was a small stump that had been left behind. 3 weeks in hospital with IV antibiotics and a nutrient drip it cleared up without surgery and the threatened stoma. Then a year later something similar but luckily it was just Crohn's flare up. He was then put on steroids which resulted in weight gain which he is struggling to lose. Fortunately no diabetes, though he does eat low carb as I do so maybe that helps.
He was taken off the original medication and takes nothing at the moment.

Anyway you must have hypo treatments with you at all times, many people use jelly babies, glucose tablets, full sugar coke 150ml cans.
 
These events can be very scary, my other half has had Crohn's for many years but largely asymptomatic with the very occasional flare up, he was taking a medication which seemed to manage it. But he suddenly got a severe attack with a very high heart rate but it did seem very different to the usual. We ended up going to A &E where they said he had a perforated bowel due to appendicitis which given he had his appendix removed some 50 years before but it was a small stump that had been left behind. 3 weeks in hospital with IV antibiotics and a nutrient drip it cleared up without surgery and the threatened stoma. Then a year later something similar but luckily it was just Crohn's flare up. He was then put on steroids which resulted in weight gain which he is struggling to lose. Fortunately no diabetes, though he does eat low carb as I do so maybe that helps.
He was taken off the original medication and takes nothing at the moment.

Anyway you must have hypo treatments with you at all times, many people use jelly babies, glucose tablets, full sugar coke 150ml cans.
Wow Crohns is terrible. I find with the diabetes when my gut needs to be cleared I can eat something like a scone sugar free jam and cream and most of the time it works if not it’s meds.
I have set my freestyle Libre 2 to 4.0 to 9.5 and I am running at 97% in target and I think that is good I wanted to set it to 8.5 but the nurse said set to 10 or you will keep having spike alarms..

What amazed me when I was told I was a diabetic it was on a 5 minute phone call with no questions allowed I found that very irritating

James
 
Wow Crohns is terrible. I find with the diabetes when my gut needs to be cleared I can eat something like a scone sugar free jam and cream and most of the time it works if not it’s meds.
I have set my freestyle Libre 2 to 4.0 to 9.5 and I am running at 97% in target and I think that is good I wanted to set it to 8.5 but the nurse said set to 10 or you will keep having spike alarms..

What amazed me when I was told I was a diabetic it was on a 5 minute phone call with no questions allowed I found that very irritating

James
I think some people do set their low alarm a bit higher than 4 so they get more of a warning they are approaching hypo territory so can take action in better time.
 
I think some people do set their low alarm a bit higher than 4 so they get more of a warning they are approaching hypo territory so can take action in better time.
So 4 may be a bit low what about the 9.5. I was told 10 but I started with 8.5 and even then I am still 92% in target and this include the steroid injection in 4 parts of my spine before they burn the nerves.

James
 
Thank you so very much. It is a pain sorry for the pun but boy it is.
I think as long as I can keep my colitis out of a flare I will be ok

I will have to add to the main forum how I ended up getting a Libre 2 with type two even though every one was saying no or that person can do it but no they could not. It has really helped.

One thing I am not use to are the lows when we went on a walk and I had an alarm at 2.2 the glucose gel just did not cut it and it was very scare because I almost fell over a number of times and I am not sure I would of gotten up again. I think a hypo emergency pack may be a good idea. May be a gel and the sugar things but also a drink but all small enough for my wife to carry in her bag

Does anyone have any advice on this.
James

Set your Low alarm higher @James Foote Think of it as an alert not an alarm: it alerts you so that you can ward off an impending hypo. Also, if you know that walking drops you (as it does most people) then top up with a few carbs beforehand.

You don’t need to set your High alarm at 8.5. It’s unnecessary and is potentially putting you at risk of more hypos.

Good hypo treatments are Dextro glucose tablets, regular sugar Coke or Appletizer, Lift Glucose shots, etc. Always carry them (and plenty of them) along with some longer-acting carbs like biscuits or cereal bars.
 
Set your Low alarm higher @James Foote Think of it as an alert not an alarm: it alerts you so that you can ward off an impending hypo. Also, if you know that walking drops you (as it does most people) then top up with a few carbs beforehand.

You don’t need to set your High alarm at 8.5. It’s unnecessary and is potentially putting you at risk of more hypos.

Good hypo treatments are Dextro glucose tablets, regular sugar Coke or Appletizer, Lift Glucose shots, etc. Always carry them (and plenty of them) along with some longer-acting carbs like biscuits or cereal bars.
Thanks yes I now carry though two packs. Are you saying I should set to 10 sorry I am still use to my meter and the two hours after.

Thank to every one for the advice.
James
 
I set my high alarm at 13. You should do what works for you, of course. The Time in Range can be obsessive. Aiming for too high a percent of TIR, especially when you’ve got other things going on, is stressful and not necessary. I’m not saying it’s good to be 17% TIR, for example, but as a Type 1 we’re told that 70% TIR is excellent. It’s all a balance between keeping control and living your life without handing over your brain to the diabetes.
 
I set my high alarm at 13. You should do what works for you, of course. The Time in Range can be obsessive. Aiming for too high a percent of TIR, especially when you’ve got other things going on, is stressful and not necessary. I’m not saying it’s good to be 17% TIR, for example, but as a Type 1 we’re told that 70% TIR is excellent. It’s all a balance between keeping control and living your life without handing over your brain to the diabetes.
Ow I get that it can be like a full time job. I am a very anal person and love information so the Libre is a great bit of kit I am still using the reader but when I change my phone battery I may have a go at that.. if I set my reader to high 10 then my last 90 day in range is 99% my only reason on reducing the 10 was to make it a little harder on myself without going totally mad. Things are working for me right now apart from the 2.2 disaster but by making it a little harder means my next colitis flare will be easier to deal with, I think.
I don’t know if regular losing blood even is it is not showing red just very very dark if this is problematic to my diabetes or not I know the fatigue is and the steroids cravings OMG that is just nuts I can just deal with the morphine cravings when I am maxed out.

Thank you for your advice I really do appreciate it
James
 
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