I had to get a cortison shot for my knee yesterday. I knew my numbers were great — like 180’s for the last month. But it was a matter of being able to walk, or not get anywhere. I’ve scheduled knee surgery for May…that all said. This morning I woke up to a 437 — the highest I have ever had and even so with the cortisone and eating not so well.
I called the clinic, got told to stick to a straight low carb diet and drink plenty (LOTS) of water today, and get on that bike or in the pool. Later my numbers were down to 300’s and that’s around normal for after a shot. I need to get one more before the end of the month in the other knee…and then no more because of the surgery…they want me to be “normal” for at least two months before surgery.
so I freaked out, and maybe that’s what I needed was to have a very high number to get back on track.
What kind of information or treatment do you do when you get very high numbers.?
Their advice is fairly good. I would stick to a very low carb diet and some light exercise during this time, to lessen the impact of these shots, and drink plenty of water. There’s lots of advice on this site, for recipes, and snack ideas. I don’t know if you can consume any alcohol, but if you can, you may enjoy a salad with a bit of red wine vinaigrette, as red wine can help lower blood sugar. The liver will stop processing carbohydrates, in order to process the alcohol, and thus causing blood sugars to drop. Do not abuse this though, as too much can be bad, as well.
So sorry, Cathy. Eeek, 437!
Exercise isn’t advisable when BG is over 250. Exercise causes the release of counterregulatory hormones, which can make BG go even higher. There’s also a greater risk of further dehydration by sweating when exercising.
Drinking lots of water helps. Eating low carb is a plus when you’ve got to take cortisone shots. Eating low carb is a plus anytime:)
Know you’re Type 2 & not on insulin, but perhaps you could talk to your doctor about taking insulin when you’re due for your next cortisone shot. With BG of 180 for a month, you need insulin to get your numbers down since your meds aren’t helping much. More normal BG is critical before surgery.
Aw, Cathy. That’s horrible. I’m a type 1, and when I get a cortisone shot, my insulin needs shoot up to twice my normal needs for 3-4 days. I had never considered what steroids must do to my type 2 friends. I agree with Gerri. You need to ask your doctor for some better solutions.
I wouldn’t work out when that high either, honestly. But drinking lots of water would certainly be my best advice. It’s easy to become dehydrated or develop ketones if you’re riding that high.
Yikes! I am glad you posted this, and so sorry that you are going through it, but I have foot issues and was thinking of getting cortisone shots in both feet to allow me to at least leave the house and maybe get back on the treadmill and lose some of the weight i have put on since being unable to move.
Not sure I want to muck with my BG numbers like that. I am pretty well off, T2, and I think, tightly controlled, but still, this makes me rethink the doctors ideas.
Anyone wanna comment on how normal this kind of rise and remaining high is when getting cortisone injections? Makes me stop and think.
I hope you get it corrected quickly, but I hope you know how much I appreciate hearing other’s experiences that mean so much to decisions that we all have to make.
Cortison is a steroid and decreased the effectiveness of the insulin receptors and therefore your insulin basal dosage and carb ratio may have go be changed. My basal need increases by about 20% and the carb ratio changes by about 15%. This change last for about 3 to 10 days depending on the type of steroid used.
If the MD did not tell you this, they are guilty of malpractice. It is common knowledge in the Med community. The Low carb diet is wrong, if not combined with increasing insulin. Also the BG to Unit lowing calculation is out of whack also.
If you are on the pump you can program a basal rate to accommodate the increased need.
Getting on the bike may have no effect, depending on how sensitive your insulin receptors were before the shot.
I’ve had several steroid shots for various injuries, hands, shoulder, elbow and knees to name a few. It is a bit of a challenge to manage the impact, but you have to be patient and trust the corrections and understand what impact the steroid has on the insulin.
Thanks for the noting the mistake Gerri, We have to stay humble here don’t we.
The same insulin receptivity issues apply and with a BG of 430 and 300 she may want to reconsider what the MD has diagnosed. In may help if she uses insulin during the steroid. This would reduce the load on her islet cells and may prevent complications and further damage to her pancreas and insulin production.
I would also ask the MD for an A1c to see if the BG are really 180 and not higher. All to often, the medical community does not treat T2D with the respect it needs. There are several options and potential issues that are missed by MDs when treating T2.
Similyn may a great option for the temporary insulin effectiveness issues. It can help digestion, BG and insulin receptivity.
Agree that doctors are often complacent about T2 & too many are misdiagnosed. Read too many stories here of T2s with soaring BG who are also dealing with side effects from oral meds. It takes time to educate patients about using insulin & it’s easier to prescribe pills. Their reluctance to discuss insulin & their fear of liability because of potential hypos is a disservice.
Good point about an A1c given the inaccuracy of meters, how we really can’t know about all possible highs & that T2s aren’t encouraged to test as frequently. Wish A1cs were standard screening for everyone.
Symlin helps many T1s. Do you take Symlin? Wish I could, but I have gastroparesis.
The cortisone did it. As a Type 1, everytime I have had one in my shoulder, my sugars 12 hours later were in the 500-600 range and stayed 350 or higher for 2 weeks no matter what I did to bring it down, more insulin, more water, increasing basal on pump, not eating fats or carbs, etc. My kidneys would ache and I couldn’t get out of the bathroom for more than 30 min. I had 6 shots to my shoulder over 2 years and the doctor said “Why aren’t you controlling your diabetes better?” and I looked at him and said, “You are giving me steroids and my Endo said do surgery and no more shots!” He got mad and told me to find another doctor to fix the shoulder. All I said was, “Thanks for my problems you created!” and walked out. Please consider insulin at least until your BS is under 130 for a few months before surgery because you won’t build up as much scar tissue if your BS is almost normal.
Thanks for all the information. My CNP (remember we are in the boonies in SD and have to take what medical people we can get.) advised the exercise, which felt better, and made things go easier yesterday. My numbers will slowly come down, as someone stated. The decrease in pain, which causes them to go up – pain wise, is worth the shot. I am having these knees fixed in the spring, no crutches for me in blizzards and on ice. So the problem of cortisone will be removed at that time.
I have been eating lots of low carb foods, drinking water like crazy, and being extra careful not to miss any meds. I am in a very strict diabetic program in South Dakota, tracking the T2’s and 1’s in our state, since we have a high Native population. My medical people even though not all medical docs are very, very highly educated in the treatment of diabetics, so I feel that their medical knowledge is great. I do trust them, most of the time…but I am still in control. Stress over pain is a big BIG trigger for me, so when that is gone, my numbers are reduced also. Maybe I didn’t explain that well enough. I guess I did freak out at the high number, as it had never been that high before. I haven’t been very faithful to my diet, and exercise needs during December and part of November, I just didn’t care…diabetic burnout…which I found out can really hurt me, so I have to have a plan to work on that period of time…when I just don’t care. That is why I am so adamant about making this normal for me…not a BIG DEAL!
So thanks again, any other suggestions greatly appreciated.
I’m not using it. I know some people on Team Type 1 who swear by it to lower their insulin needs and increase the receptivity. I have enough to figure in the mix so I’m not going to try it for now. My insurance does not have it on the formulary.
I’ve read of several studies recently release that come to different conclusions. Some say that T2 who use frequent BG test to manage their D are not any better off than those who do not. Other recent studies have shown that using BGs to look at the results of different foods post meal greatly improves the D management in T2Ds. Canada has recommended that the stip coverage for T2Ds be lowered because frequent tests do not improve #s. I have to assume that they did a poor evaluation of the different factors that impact “improved” A1cs.
Kaiser in Oregon has lowered the allowable # of strips for both T2s and T1s in their formulary (in another discussion on tu).
I hear you on having yet another thing to figure you in. Wonder how common Symlin coverage is. I was excited to try Symlin until I read that it slows digestion. I have enough problems with this already!
Hard to know about studies because some are designed to reach a predetermined conclusion. Always interesting to research who funded the study. As Mark Twain said, “There are lies, damned lies & statistics.” Seems reasonable that testing frequently could only be advantageous.
I sent an email to Kaiser about that bs. Letter I sent was posted on Judith’s discussion. I got no reply. Big surprise, huh?
Hey Stephen and Geri,
Im a T-2 and I know testing after before and after meals has helped me greatly get better control. Do I do it after every meal like a T1 no, but I might check breakfast one week and lunch the next week. My Dr says the insurance wont cover my extra tests, they only cover twice a day. Im on my my own babe for the extra test strips.
I am a stock and options trader too and I was reading a stock analyst that follows meter companies such as Bayer and Roach and he said that only 50% of the T-2’s test regularly. His point was that investing in meter companies may not be as lucrative as one thinks with the onslaught of T-2’s. This likely carries over Stephen too in the thinking of these insurance carriers. Take care. Talk to ya! Hi Geri to you too!
I wouldn’t be surprised if the testing study was funded by the insurance industry. How could testing frequently be anything but helpful? John Brush has been controlling his BG by testing a lot. He knows how food effects him. Sure there are others as dedicated as John who are avoiding meds by keeping close tabs on BG by testing.
A travesty that T2s aren’t encouraged by doctors to test much. A friend’s T2 husband tests a couple times a month, if that much. I had to tell him that strips expire since he uses so few.
Have you contacted your insurance company to find out about strips? Some doctors aren’t willing to go to bat to get what’s needed. Awful to have pay for them yourself.
Send any hot stock tips my way:))
Hi Geri, Well Im working on it. I am having it reviewed. For as big a cost as T-2’s are to the insurance companies wouldn’t this fall into the preventative category of costs. Right now the Dr only has me testing morning and night. At least that is what the prescription says.
I know John has had great success and his story should be highlighted in DLife or something. UMMM maybe we can talk him into it. LOL
I know some other T-2’s that say, well may A1C is fine whats the point of testing… This just urks me because the A1C is such a small part of it when you look at the whole as you well know. Any way nice to chat. Take care Talk to ya!
Oh right now I am watching OMNI closely with this deal in Europe with the recent approval. That stock could really take off… And with the with the growing diabetes problems in India according to the anyalsts… Omni could really take off Im watching for now though.
I am a trader to my own state though and should have stock in Medtronic, Medtronic is just down the street from me but they are going sideways and not to bullish at the moment…ummmm
Well, insurance companies have never been supportive of prevention. Guess they’re more interested in immediate costs & drop people or raise premiums when a condition becomes expensive. Insane.
Agree that just going by A1c is not helpful or healthy.
Hope you win the battle for more strips.
Great idea about John being featured in DLife!
I am very happy to report that my blood sugars have gone down significantly — like below where they were before i got the cortison shot. I think the question is quality or misery. When my knees are in pain, and you can’t believe the pain that bone on bone makes, it’s a rise in my bs’s…much more so because of the stress of the pain. It is worth the cortison shot, and I would (will) do it again. The thought about quality of life comes into my mind, I can either live in pain with this arthritis, or I can do what I know works and what all my team says will not kill me if I do it on a better schedule rather than once every 6 weeks.
When I’ve tested today, my numbers were much lower than they have been in a long time…in the 120’s down to 80’s. For me I’ll take than, and the lack of pain in my knees