how long will cortisone injection cause elevated bgs? - Diabetes Message Board

beanstock · 10-07-2008, 11:17 AM

I'm type 1 diabetic and on Friday (five days ago) I got a steroid injection for frozen shoulder. I was warned that my blood sugars would be elevated, but this is ridiculous. I use a pump and I have a temporary basal setting of 150%, and yet my bgs are still running near 300. And I"m eating like an Atkins convert -- avoiding carbs, hoping that will help. How long will this last?

itotito · 10-07-2008, 11:36 AM

Quote:

Originally Posted by beanstock

I'm type 1 diabetic and on Friday (five days ago) I got a steroid injection for frozen shoulder. I was warned that my blood sugars would be elevated, but this is ridiculous. I use a pump and I have a temporary basal setting of 150%, and yet my bgs are still running near 300. And I"m eating like an Atkins convert -- avoiding carbs, hoping that will help. How long will this last?

I don't know how long it will last, but my understanding with cortisone is that it causes insulin resistance as well as increases glucose production.

Insulin resistance may be something you have never dealt with ? I don't know if T1s struggle with it

A few different drugs have sent me for a loop.

The only way I know to immediately reduce the insulin resistance is through excercise.

Did you try a little extra walking or 15 mins on a treadmill ?

Go slow. I have experienced kind of like and insulin buildup that when I started excercising caused me to drop rapidly. As though the insulin was there, not being utilized and the excercise just opened the flood gates.

I once sat at 200 for like 4 hours and dropped to 70 within 20 minutes when I ran.

Please let us know. The effect of cortisone, cortisol and other steroids has a huge impact on us diabetics.

SamQKitty · 10-07-2008, 11:38 AM

It depends somewhat on how much cortisone was injected, along with individual variations in body chemistry.

I just got a cortisone injection for a trigger finger yesterday, and I've got my temp basal set at 133%, and will keep it there until tomorrow evening, when I'll probably be able to set it back to about 120%. For me, the effects are usually gone within about 4 days, sometimes 5.

One of the things I've learned over the years (and with help from a really terrific rheumatologist) is that it's much easier to keep bg's from going high in the first place than it is to get them down once they've gone up there. For that reason, I usually set a temp basal at about 120% IMMEDIATELY upon receiving the shot, then set it up to 133% about 2-3 hours later, and keep it there until I start seeing lows...then I can start decreasing back to my normal basal rate.

Not sure if you increased right away, but if not, it'll probably take another day or two (or even 3-4 more days) to get back to normal. The one time I did not set my temp basal up right away was when I had hand surgery and wasn't told that they would be giving me a steroid to reduce swelling...I couldn't understand why my bg's were so high after surgery and why they wouldn't come down until the next day when I got the follow-up call from a nurse. When I mentioned that the only problem I was having was my bg control and said "gee, if I didn't know better, I'd think you guys had given me a cortisone shot while I was unconscious," she looked up what the anesthesiologist had given me and, sure enough...cortisone!!! I was royally p.o.'d, and ended up teaching the surgical suite manager my steroid protocol, which they are now using for all their diabetics...but they're also no longer giving steroids without first asking/informing their patients. Because they hadn't told me, and I therefore hadn't set my basal rate up right away, it took about 4 days before I could get my numbers back to anywhere near normal.

Good luck getting those numbers down...it's so frustrating, I know.

Ruth

itotito · 10-07-2008, 12:51 PM

Hi Ruth,

What role if any does insulin resistance play for T1s in such a situation ?

beanstock · 10-07-2008, 01:27 PM

Itotito,

My own experience with insulin resistance is that, while insulin resistance itself is not a problem for me as a Type 1 (I think that's more symptomatic of T2s), certain things can make me insulin resistant. Like a high fat diet, or high blood sugar itself (once I'm high, it takes more insulin to get me back down than it would have taken to prevent said high) or, apparently, cortisone injections. So T1s definitely become insulin resistant in certain situations.