Just saw this post. My two cents…
I used to have to get cortisone shots 2x a year for osteoarthritis. Drove my bg sky-high basically until the shot started to wear off (about 2 mos). Had to go up 2 units on my basal, and an extra unit on boluses. Then I had to guess, by my pain level, when to start experimenting with going back down. Or just wait for a morning when I woke up in the 30s. My PCP said it was most likely making me insulin resistant, which I never was before. No endo has been able to explain this. But I’ve had bad luck finding good endos…
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I just had a cortisone shot last week. Based on my prior experience, I immediately raised my Tresiba by 2 units and was more aggressive on corrections, and as a result, blood sugars occasionally spiked a little more, but nothing too bad. Back down to usual basal dose at day 5, but since it’s Tresiba, overlapping dose still in my system which has worked out ok.
I would absolutely recommend primarily basal changes not bolus when dealing with this—way more effective than chasing highs constantly.
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Also, having had… 6? cortisone injections to date I think, ones in joints with bursitis weren’t worth it, but ones for my frozen shoulder (which is close to resolved in the left but now occurring in my right, but this time trying to head off early) absolutely have been, resulting in almost immediate decrease in pain and increased mobility that can be maximized with PT.
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For me it’s weird, I can double my Tresiba and it still won’t cut it. I can take a 12 of Afrezza and won’t budge. I have to take a LOT of Novolog to even budge it. I’ll take 10units then wait, nothing. 10 more, nothing. 10 more then it will start dropping.
I am getting the Tandem pump soon hopefully as I’m tired of doing everything myself.
But I’m actually going to get PRP as cortisol just seems to be a bandaid for me. I read a lot on Dextrose Prolotheraphy and PRP and people seem to have really good almost permanent results with it. All out of pocket though.
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I am anticipating my upcoming hip injection. I am glad to have been reading this thread. But I did discuss it previously with my endo bc I have had to take Prednisone a long time ago while on insulin and it was a memorable nightmare.
Currently I am sick with some sort of seasonal virus. Not only have I had to increase my Basal Rates (120%) but I have had to strengthen my ICRs and my ISF as well. I am using DOUBLE my usual dosage to do corrections as needed, but the adjustment in my ICRs has been tremendously helpful. However, that being said, none of this worked until AFTER I increased my basal insulin (NovoLog) (and btw, I am on the pump, which had made things much more manageable.Once I made the changes, I have been able to not only to stay below 180, but to remain between 70 and 115). Best wishes and prayers 
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