Thanks! I have used steroid eye drops briefly in the past, but at the moment I’m using a steroid inhaler, nasal spray, and (strong) cream. I’ll have to do some research when I get home and see if I can find anything about these affecting blood glucose. There are lots of anecdotal reports of these medications affecting control in forums and Facebook groups (specifically those in which people aim for tight control).
It’s interesting, though. This morning in the half hour since getting up my BG has jumped up by 2 mmol/L (36 mg/dl) without eating anything. So hopefully that’s just a “feet on the floor” thing and not a sign that I’m going to continue rising all day.
Inhaled steroid goes directly into your blood, so not really considered topical https://www.bioportfolio.com/resources/trial/73727/Effect-of-Inhaled-Steroids-on-Glucose-Regulation-in-Asthma-Patients.html. Steroid in your blood will definitely screw with your BG by increasing insulin resistance, so trying an alternative is a great idea.
Oh yeah, steroids usually wreck blood sugar control, and an inhaled steroid should definitely have an effect systemically. I would not consider that topical.
I guess I was thinking topical because I thought it only affected my lungs. I also sometimes take a swallowed steroid for my throat. So looks like I’ve got four medications to try and replace.
Hmm, usually inhaled things have a very direct route to your blood stream (usually much faster than through the digestive system and subq injections, like with Afrezza), but I guess it depends on whether a steroid can cross the barrier in your alveoli. You’d have to look that up—I was originally thinking it would, but I’m not totally sure.
I am glad that you have a good relationship with your endocrinologist! I feel like the more people on your team, the better.
And I assume that Graves disease is something that your endocrinologist could help you look into – with thyroid bloodwork and what not?
On that note, it might be worth a phone call to your Endo’s office to request the blood work before you get there – to ask them to add any tests that might reveal what is going on to the existing bloodwork request.
At least in with the endocrinologists we have seen, we generally go into the lab the week before with an order for blood work, so it’s a recent draw to discuss.
I send a note to the Docs about 3 weeks in advance to get the process started. That usually gives enough time for everything. My goal as @TravelingOn mentions is to be able to discuss the results of the lab work in person with the Doc during the visit.
Last time it took us a month to get a fasting BG draw though, because EH was drifting low every night, and eating candy to correct that, and then it wasn’t fasting. The one time it was fasting, we got in there, and he was at 62 and it was an hour long wait. We turned around and went to the nearest diner for breakfast.
Fasting BG draw is part of the routine tests that are ordered for us. (It is just a standard test on the CMP panel.)
I totally ignore it. We don’t fast. I find the BG number reported to simply be amusing.
(My focus clearly is on the other portions of the testing.)
What about fasting for cholesterol?
EH is also under the impression that fasting doesn’t matter, but I kind of feel like removing that non-fasting is part of limiting variables.
The current recommendation is that fasting is no longer required for general purpose lipid testing. However this is cushioned by advice to avoid a high fat meal before the test. So if we are getting lipids (which is not every visit with the phlebotomist) we would have low fat foods for breakfast.
For certain lipid testing that may be a follow-up or looking at something more specific, fasting may still be appropriate.
Haha. My boyfriend is always right. Better not tell him – I don’t want it to go to his head.
I agree that there may be a choice of various “steroids” or “cortisones” that can be used, but that have hugely different effects on BG. On another forum I read a discussion of two particular pills that were both suitable for treating whatever was under discussion there. One (in the glucocorticoid family) raised BG significantly, whereas the other (a corticosteroid) had no significant effect on BG. I don’t remember the names, and that forum no longer exists so I can’t be more specific. But asking your doctor for alternatives may be fruitful.
So I took a two-day break from my steroid medications. Blood sugar definitely wasn’t perfect (and I did raise my basal rates by about 0.4 u/hr and lowered my carb and correction ratios slightly 'cuase of hormones), but BGs were running noticably lower. Today I woke up extremely congested, so I took my nasal spray and inhaler (both steroids). Since about noon (It’s just about 7 pm now) my blood sugar has been 15-19 mmol/L despite pump corrections, an IM correction, running a +100% basal, and a site change. I’ll do some more experimenting, but this seems to be confirming that it may be (in part) these medications wreaking havoc on my blood sugar. Why they only started affecting me now, I don’t know, but definitely something I need to look into…
As a scientist I figure that data is always good. But this is really too bad Althogh better than the alternative: no rhyme nor reason.
Yeah, I’m still experimenting. Today I took all medications and upped my basals by another 0.2 u/hr and still spent several hours high (and began rising right after I got up, even before taking medications). So maybe a combination of factors. Still super annoying!
What level of steroid do you take daily?
Aside from BG issues, steroids can have cumulative and long term effects.
If you can find another approach that would work you might get a double win.
These aren’t oral steroids. I’ve been offered oral steroids twice in the past and declined (I don’t plan on using oral steroids unless I’m dying). That’s partly why I’m not sure if they’re actually affecting my BG. I’m just trying to find a reason for why my BGs are so crazy!
But the doses I’m on are 200/6 of Symbicort (I’m going to ask for a much lower dose next time I see my doctor), 50 mcg of Nasonex, and 0.05% Clobetasol cream twice a day (this I’ve tried lower doses of steroids and still had severe eczema). And periodically I take 125 mcg of Flovent (for my throat, not inhaled).
This is all in addition to taking prescription-strength antihistamines every day, antihistamine eye drops once or twice a day, saline nasal spray several times a day, and allergy desensitization shots for the past three-plus years. And trying to make my apartment an allergen-proof bubble.
I’ve lost track of exactly what’s happened, but the craziness has continued. When I look at my 24 hour Dexcom graph I see very little in range. Over the past 48 hours I’ve had to use 75 grams to cover a single half hour workout (that I don’t think was all that intense!), gone low while “working out” at work (i.e., walking around doing my job), and had to eat 65 grams of carbs overnight to treat three LOWs on my Dexcom (only one of which I bothered to test for, and sure enough, 2.3 mmol/L on my meter). So over the past 24 hours I’ve lowered my basal rates by 0.5 u/hr, which almost reverses the 0.7 u/hr that I raised them over the previous few weeks, and makes me think I’m “just” dealing with hormones after all.
I’m still experimenting with medications and I do believe they may play a role as well, but everything is so freakin’ hard to figure out right now with so many variables at play.
I’m too hungry to skip breakfast this morning, but I’m eating a zero-carb breakfast and plan to skip lunch. I’m not sure it’ll do any good, since tomorrow’s schedule is totally different from today’s and ditoo for Sunday, and by Sunday who knows how hormones and other things may have shifted, but at least maybe it’ll keep me off the rollercoaster for today.
Also, I noticed on my fitbit that my resting heart rate has been rising steadily over the past month and is now hanging out in the 90s, and I’ve been spending 10-15+ hours with heart rate in the “exercise” zone on many days (I don’t exercise that much!), all of which reminds me of exactly what my fitbit showed when my thyroid was hyper. It’ll be interesting to see what results I get when I have it checked in a week or two. I’m taking medication to block my thyroid from making hormone, but my body is still making antibodies that attack my thyroid’s TSH receptors (which is why my thyroid makes too much hormone), so really anything is possible each time we check it. To be totally honest, it would be nice to have a reason that I can actually control behind my blood sugar craziness, so I would not be upset at all if it’s high.