How much do Steroids increase BG?

Hello,

This is my first post, and although not a DAFNE graduate, I've been T1 for 45 years and managed to keep my BG pretty well controlled and so have no complications, even after this long time.

In April 2013 I was diagnosed with another autoimmune disease called Vasculitis (inflammation of the blood vessels) and so I now have to take steroids (Prednisolone) and also an immuno-suppressant (Azathioprine - Imuran) to stop my immune system from attacking me.

Two years ago I taught myself detailed carb counting / bolus adjustment and record everything on a detailed spreadsheet, and have achieved HbA1c levels of about 6.5% since then. I no longer take a BI since Lantus caused me ovrer night hypos, and so just do QA Humalog per meal.

BUT ... I have to have increased bolus dosage to cover the total BG, which is made of:-
1) to cover raised BG from variable inflammation (slowly reducing as drugs take affect)
2) to cover raised BG from Prednisolone dosage of 15mg currently
3) to cover carbs based on known IC Ratio at each meal

So .. my question is ..."How much BG will increase due to 15mg of Predisolone steroid"?

Thank you .... Jonty

have you asked your diabetes nurse specialist or your consultant ? they should be able to help you

No I haven't since I'm unable to email my diabetes consultant and have never had a need to contact my DSN since I 'seem' to know all the answers. But I do have her email/phone no. so will try on Monday.

It is an interesting question that few people know the answer to I suspect. I vaguely remember someone on another forum saying that she was advised that it was 1mmol/L per 20 mg, but I may be wrong.

Thanks for the reply anyway ....

It will likely differ for each person. If you were able to miss a dose of Prednisolone, you could compare what happens to your BGs when you do take it compared with when you don't. I don't know how comfortable you would be with missing a dose though, so that would only be an option if it wasn't going to cause other health issues.

Hi, please DO NOT miss a does of prednisolone, it is not a drug you can experiment with. Steriods are a serious drug and you should always follow the dosage instructions. Warick is correct in that it will vary from person to person and unfortunately its effects are not linear either. The problem with Steriods is they cause insulin resistance and as I said it can vary all over the place. I had the pleasure of taking them for 2-3 months for Nephrotic syndrome ( another auto-immune disease) and had great fun with BG levels going haywire.
You just have to manage best you can and try to adjust your doses accordingly.

Another important point, that no one told me, if/when you stop taking them (usually you are weaned off of them) you insulin sensitivity can come back with a bang. Had my only severe hypo coming off steriods.