Jump to content

Photo

Prednisone and insulin adjustment

- - - - -

  • Please log in to reply
10 replies to this topic

#1
NoNora

NoNora

    Junior Member

  • New Members
  • Pip
  • 5 posts
I've read a good deal about the high BG experiences of diabetics and several forum members mentioned changing their basal and/or bolus. Could someone be more specific and tell me what they did with their dosages that helped?

I'm on a 2 week course of this drug and spent my first day largely between 275 and 420 - it took what I consider MASSIVE amounts of insulin to bring it down at all.

Sadly, I'm in the painful position of the doctors having tried everything else, and this prednisone course is an absolute must -I really can't choose not to take it and would really appreciate any specific advice anyone can offer.

Also several people mentioned the BG effects lasting AFTER they stopped taking the prednisone. For those of you who have experienced this, how long after.

Thanks so much.

#2
GrammaBear

GrammaBear

    Senior Member

  • Seniors
  • 1,921 posts
  • LocationNorthern Illinois
  • I am a:Type 1
I did not take prednisone, but another steroid in the form of a topical ear drop (which wasn't supposed to elevate my bg, but it did!). I can tell you that my bg was also high like yours and it took massive doses of insulin above what I normally use to bring it anywhere near my target range.

Please talk with your doctor or at least his nurse or someone who can give you professional advice. I am on a pump and did a increase of 50% temp basal up to an increase of 80% temp basal. In addition to that I changed my insulin to carb ratios in half - meaning if my I:C for a meal was normally 1 unit of insulin for every 10 carbs - I changed it to 1 unit of insulin to every 6 carbs.

Again you have to "play" with the I:C ratio until you find what works for you. Be cautious when changing your rates especially if this is your first time with prednisone. Oh......and don't forget to check with your doctor.

#3
SueM

SueM

    Senior Member

  • Seniors
  • 1,413 posts
Hi,
the rule of thumb is it takes about 2 units of insulin to 1 mg of pred. (endo told me this)
Basically though you need as much insulin as you need.
Hope this helps.
Sue
Pumping using bovine insulin. (Pump kindly donated by Solox)

#4
NoNora

NoNora

    Junior Member

  • New Members
  • Pip
  • 5 posts
Thank you both so much for sharing your incredibly helpful experiences with me. I've just moved to a new town, across the country from my old diabetes physician, and was unable to get an appointment with a new doctor until late next week - so I really was on my own for the beginning of this. I'm already controlling it better. Thank you both so much.

#5
GrammaBear

GrammaBear

    Senior Member

  • Seniors
  • 1,921 posts
  • LocationNorthern Illinois
  • I am a:Type 1
You're welcome for any benefit you have received. Just please remember to test and test often while taking the prednisone and do be careful with your bg levels. Let us know how things go for you.

#6
NoNora

NoNora

    Junior Member

  • New Members
  • Pip
  • 5 posts
WOMEN!! You are a godsend. Today is going phenomenally well, given the steroid challenges. No blood sugars over 200 and the day is half over. Changes to both basal and bolus really made a difference. Thanks from the bottom of my heart!

#7
GrammaBear

GrammaBear

    Senior Member

  • Seniors
  • 1,921 posts
  • LocationNorthern Illinois
  • I am a:Type 1
I'm tickled you can benefit from what I had to learn the hard way. When my doctor gave me the topical steroid ear drops I was told "No, the ear drops can't possibly cause elevated blood sugar readings". Me.......OK - then maybe you can offer an explanation of why my bg went off the chart less than 8 hours after I used the drops the first time ???

It took me almost a week before I got an answer from the local pharmacist that made sense. Everyone is different, but you will want to be real careful after you come off the steroid. It took me almost a month before my bg returned to normal. Other people have said it took them about a week. Go figure.......:)

#8
SueM

SueM

    Senior Member

  • Seniors
  • 1,413 posts

WOMEN!! You are a godsend. Today is going phenomenally well, given the steroid challenges. No blood sugars over 200 and the day is half over. Changes to both basal and bolus really made a difference. Thanks from the bottom of my heart!


Wow I'm glad things are improving for you :)
It was explained to me when I 1st went on steroids (pred) that it lasted a fair few hours so to increase basal and then top up with bolus as needed.
Last year I needed an emergency admission to hospital and ended up with 500 mg of hydrocortison in 24 hours,. I managed not to go over 9 mmol the whole time. Even the Dr was impressed with that one. That involved a 220% basal plus top up of bolus.
Do be carefull though and monitor your blood sugars more often so you can see how things are going.
Also for safety make sure you have plenty of hypo treatment handy incase you drop lower sooner than expected. It's better to be safe than sorry.
Sue
Pumping using bovine insulin. (Pump kindly donated by Solox)

#9
Deetles13

Deetles13

    Junior Member

  • Members
  • PipPipPip
  • 58 posts
This is very helpful.. as I also just started prednisone yesterday for psoriatic arthritis inflammation.. my sugar hasnt been below 200s and Of course I had been doing really good just before that.. i changed my basals and my I:C in half will see how that goes.. i have been logging everything so that when I get to speak with my doctor I have it all ready.
Native American
Type 1 since Feb 11, 1998
Pumper since Aug 2006
A1C 11/2008 8.2%
2/2010 7.6%
10/2010 6.8%

#10
HeartMan

HeartMan

    Member

  • Members
  • 366 posts
I'm a long term transplant patient and have diabetes due to the anti-rejection meds I have to take, the main culprit: prednisone.
I still have my detailed log from 6 years ago showing my dosage of prednisone (started at 50g twice a day) and the different amounts of insulin I needed, along with my glucose numbers throughout the day. As my prednisone dose was tapered, my records show how my insulin needs decreased. For a short time I was tapered off prednisone and didn't need insulin, but the docs determined my adrenal glands weren't working and put me on a small dose. It was enough to push me back into diabetes range. I could tell from my records what amount of insulin I was going to need, but I did check in with my Certified Diabetes Educator to adjust for a newer long lasting insulin and taking prednisone in the morning instead of twice a day. My CDE was glad I kept the records and gave me good instructions.
Post Transplant Diabetes 2004
FreeStyle Lite, Accu-Chek Aviva, Contour USB meters
NovoLog & Levimir Insulins
A1C 04/10 5.8
A1C 08/10 5.6

#11
SueM

SueM

    Senior Member

  • Seniors
  • 1,413 posts

I'm a long term transplant patient and have diabetes due to the anti-rejection meds I have to take, the main culprit: prednisone.
I still have my detailed log from 6 years ago showing my dosage of prednisone (started at 50g twice a day) and the different amounts of insulin I needed, along with my glucose numbers throughout the day. As my prednisone dose was tapered, my records show how my insulin needs decreased. For a short time I was tapered off prednisone and didn't need insulin, but the docs determined my adrenal glands weren't working and put me on a small dose. It was enough to push me back into diabetes range. I could tell from my records what amount of insulin I was going to need, but I did check in with my Certified Diabetes Educator to adjust for a newer long lasting insulin and taking prednisone in the morning instead of twice a day. My CDE was glad I kept the records and gave me good instructions.


I have addison's disease, so take a mix of pred and HC. I use my basal to compensate for the steroids. This is is quite easy to do for long term use.
Short term high dosage is a different kettle of fish though.
Pred for addison's should really only only be taken in the AM as it is a slow onset steroid compared to HC. HC has to be taken 2 or 3 times a day due to it's shorter duration.
The idea of taking steroids for addison's is to time them so they mimic the bodies natural cortisol curve.
This is also why when people are put on steroids they are told not to take them in the evening. (No sleep is the result)
Sue
Pumping using bovine insulin. (Pump kindly donated by Solox)




0 user(s) are reading this topic

0 members, 0 guests, 0 anonymous users