How to combat high sugars after a cortisol injection?

So I had a ESI for my back and now my sugars are 300’s solid and no matter how much Afrezza or Novolog I taken it only comes down to like 280. Any idea of other things I can take to blunt the sugar rise? Benedryl?

Cortisone shots can definitely cause insulin resistance. You are getting a good taste of that!

First of all, don’t just rely on shots to bring it down. You will have to keep doing that over and over. Raise your basal. The shot can last a few days, so having a stronger basal for that time will help.

Raise your basal right away! That is a good first step.

For lowering it, it will definitely come down with enough insulin. If 2 isn’t enough, try 4. If 4 isn’t enough, try 6. Just keep a good eye on BG and keep an eye on the fall in case it starts to happen too fast.

Your best bets would be Afrezza or IM shots, or IV if you are so inclined to do that.


Thanks Eric that’s pretty much what I thought. Not sure if anyone had any tricks. I increased basal 100% but still not a dent. Very frustrating! And Afrezza.l literally does nothing too.

How much are you taking? Have you tried an IM shot?

I take 48 Tresiba but it’s relevant only based on what I take normally which is half that.

Like 1in needle? I haven’t but I have the needles maybe I’ll try it.

Give it a try!

On the Tresiba, I am not sure of the ramp-up time, but the problem is that after the cortisone injection wears off, you could still have the Tresiba floating around for a while.

Do you have any other basals to supplement with, like Lantus or Levemir?

I’d have to look, I think I gave it all away. How long of needle for IM? I only have 1/2 I realized.

It depends on a person’s body composition. I can get IM with a 1/2 inch needle on my calves. For other areas I will generally use 1 inch. But it just depends on how close to the surface your muscle is.

So good news is I FINALLY got it to budge…

Double 12 Afrezza’s

Bad new is, I finally got it to budge!

I find catching it at the bottom is easier than pushing it down from up top.

Although we never had to deal with a steroid induced hard to move high. That sounds super tough.

Nice job on that one !!!


Careful not to overcompensate when avoiding the potential low or you’ll start roller-coastering. When this happens to us, what we’ve found works best (for us) is to start giving Liam small 5 carb snacks when he’s under 200 and double down. Usually, he levels off nicely at between 70 and 100. The trick is to not give too many snacks.

Glad it’s finally come down for you. Nothing worse than a stubborn high (except maybe a stubborn low!) lol

I’ve had some bad lows with Afrezza and I can usually handle a log of carbs so I have to taken in a lot else I’ll be in real trouble. My first priority is not to go to hospital. :slight_smile:

If I told you the amount of carbs I ate you’d probably go into sugar high just from me telling you. :slight_smile:


I still recall the picture that @Eric posted from one of his “low binges”. It was the remaining portion of a chocolate cake. With evidence clearly pointing to the lack of utensils being used.

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That second graph actually looks quite nice to me. See after the start of the drop how there are 3 dots widely spaced, then the following dots are closer together and the line is starting to curve to the right while you’re still over 150? This looks like you are starting to come in for a good landing. If I had a graph that looked like that, I’d take 1 or 2 glucose to help catch the drop, but it might already be on the way to leveling out so after the glucose I’d check back again in 15-20 minutes to see whether the graph is flattening out even better. There’s a chance that as soon as the afrezza wears off it will turn right back up again, so I’d watch for that and take more insulin if it looked like the BG was headed higher again.

Hmm never thought about looking at the dots. It’s the double down arrows that scares me. :slight_smile:

Try to see whether the dots are starting to curl in a good direction. That can give an early hint about how things will unfold, and what to do about it. This is a fundamental skill in “sugar surfing,” and if you want lots of instruction on that skill, get Steve Ponder’s book by that title. It helps take the horror out of the arrows if you can anticipate and compensate for what is happening before things get out of hand, and sugar surfing helps do that.