So in another thread I reported high blood sugars as a result of a one time steroid injection and many of you gave me useful information as to what to expect. The doctor had said 48 hours for high blood sugars, but a couple of you reported experiencing a week to 10 days so I did temporary basal rates for that period of time and barely stayed ahead of it.
So the ten days came and went and though my numbers were not as high as before they continued to run higher than usual. WTF! I've finally learned to just "treat what I see" whatever the cause but can't help but wonder what is at play. It seems unlikely to still be residual effect from the (low dose) shot I got on 9/21, and the only other things I see are 1) weather - the timing coincided perfectly with a sharp drop in our temps from 90s to 70s daytime, 50s to 30s night time.
2) I got a gift of two vials of insulin that expire this month.
My needed changes are not meal related, but basal and ISF. My basals had ranged from .450 to .500 and now all are up to .500 and a couple will probably need to go to .525. I just made the second increase of my correction insulin: It was 35 during the day and 60 at night and I just went to 25 during the day and 55 at night.
So, weather: Looking back I didn't see a clear pattern of basal increase in June when the temps started to rise. ISF has been the same for quite awhile.
Insulin: That isn't even expired yet and my understanding is that expiration dates are usually pretty conservative. I transported the insulin in my frio until I got to a fridge.
Any thoughts? I hate taking more insulin. I lost 8 pounds since June (yay me!) and I did it by a combination of reduced carbs and reduced insulin needs.
I hate taking more insulin, too. I notice I'm much quicker to lower insulin doses when I run low than to raise then when I run high.
Around this time last year I developed what I thought was insulin resistance. I was using upwards of 70 units a day and still going high a LOT. Then, around April, it went away. During the summer for about a month I was using less than 40 units most days (and one day less than 30, which is unheard of for me). Right now I'm using around 45 units a day, which is more than I was using a month ago. I'll be interested to see if my insulin requirements increase dramatically again this winter. I definitely think weather affects blood sugar, just like everything else.
Thanks Jen. I had one very dramatic experience with weather when I lived in Guatemala and went from the temperate mountains to hot coast for a weekend. I ordered home made ravioli for a treat (yes, in Guatemala!) and my pen needle broke. I just ate it and planned to deal with the highs back at my hotel. They never came and I barely used insulin for the rest of the weekend! But since then I haven't noticed any difference in insulin needs due to weather. We shall see! You would think with losing 8 pounds my insulin needs would go down not up. Geesh!
It's just nuts how the D goes on. I think we just need to continually review our needs. A lot of people have mentioned the weather being a factor in their sensitivity, so yeah this could be it. I have never had any bother with vials that are near their expiriry date. I have thrown insulin out if it has been lying in the sun, but sure you didn't do this.
Thanks, Josephine. I do tweak my basals occasionally but it's usually just one small thing not a global change! No, the insulin wasn't in the sun. My friend brought it to me in a frio, then I transferred it to my own frio and then to the fridge
In Think Like a Pancreas, Gary Scheiner discusses climate, He says,
"Warm temperature and humidity have a tendency to cause blood sugar levels to drop. This is caused by heightened energy expenditure by the circulatory and respiratory systems as well as accelerated absorption of insulin from below the skin."
I've begun raising some of my basal rates this past week.
Aha! Did you notice a definite drop in the rates at the beginning of summer as well? That's the part that puzzles me; I keep ongoing records of changes and I didn't drop them when it got hot!
I had a steroid shot into a joint this past spring, and the orthopedist tried hard to give me a low dose and a kind less likely to affect my blood sugar, and I cannot say I saw any effect on my insulin needs.
I did press the doc on how long the steroids would last for and he was pretty vague. I think they began wearing off after a month or so (in terms of them helping the joint).
But weather? Sure, a change in weather messes up my bg's every time :-). Usually in my head, I associate fall weather with back to school and needing lower insulin doses. And a massive snowstorm putting two or three feet of snow on the driveway? It takes so many hours of hard effort to clear the driveway, it feels like any insulin at all is too much. I usually have to come in every 40 minutes or so just to have a snack to keep bg's up!
Typically when it gets hot I have to drop my basal rates. My son is also a diabetic. When he was young and on regular and NPH insulin, he would get hypoglycemic in the spring. Part of it might have been attributed to being outside and more active too. But we definitely noticed the warm weather affected his blood sugars.
I've been running a temp basal rate of about 135%...I think part could most definitely be the weather, BUT I've also had some kind of viral thing over the weekend and running a low grade fever.
Yikes, that sounds like a lot! I think I was too conservative when I had the steroid shot; I started out at 10% and only reached 50% when I stopped the temp. I wasn't as high as I started, but was still too high. I'm just changing my regular basals, as if it's weather it won't get better soon! I hope you do feel better soon though.
I took 2 injections in my shoulders nearly a year ago for frozen shoulders,. My doc told me also I should see a slight increase in sugars but that the steroid wont come out of the joint much. HA ! I knew it was not true because almost every diabetic has told me that it does effect sugars a lot. I took the injections anyway because my shoulders were causing me more pain than I could deal with and I figured I could manage my sugars.
So after a week they came close to normal but I noticed I was still using 15-20% more insulin even a month later.
I had my insulin resistance checked and it was rather high. It had always been so low it was never even looked at in the past.
I had it checked again 6 months later and it was back to normal. Scrolling back in my pump logs I see that my insulin use didn't return to normal for about 3 months after those injections.
My Endo says that it can't possibly be because the injections were long gone before that, but I have no other explanation.
My weight is stable, my food is pretty much always predictable. I look back and I see in my pump history for the past week, 38. 36. 34, 36.38,34 units for the past 6 days.
It has been pretty close to that since I was diagnosed 25 yeas ago. except for the time I had those injections and 3 months following, tapering off at the end.
Maybe it is like everything else and we react differently to different stimuli.
