First time pumping and having to take prednisone. In the past on MDI, I just kept taking correction shots. For you pumpers out there who have had to go on prednisone, what is your stragedy? Increase basals, temp basals, or just keep correcting? Both?
So far I have temp basal to 115% and decerased my I:C ratio to 1:10 from 1:15. Not even 12 hours into the first dose of prednisone and already running high for me.
Any thoughts out there? Have a 12 day course on tap and I know I will be high for at least a week or so after that.
i always just do temp basals - no reason you should be adjusting your i:c, though, and any steroids will spike your BG levels.
If you are on steroids regularly, you could set up a secondary basal rate to use when on them, or just figure out what % basal increase you need and go with that.
To me, a 15% increase sounds low, i usually run at +40% basals for steroids, but everybody’s body reacts differently.
I’ve only had to deal with cortisone shots, not longer-term oral prednisone, but I, too, have found that I need to increase my basal rate to at least 30% immediately. If I wait even a few hours, I’ll start going high and then won’t be able to get it back down.
I agree with Geoffrey that you shouldn’t need to be changing your I:C ratio, but rather do it through the basal…either temporary basal or as Geoffrey suggested, set up a secondary basal rate. You may have to tweak it quite a bit but once you’ve got it set correctly, it should be the same increase each time you need to take prednisone (although I hope you don’t have to take it ever again…what a pain in the derriere it is).
Unfortunately, once you start running high from prednisone, it’s harder to get it down, so you may have to keep increasing the basal rate, testing a lot (like every hour), and doing a correction bolus as well. Just be careful not to stack too many corrections with too many basal increases, just in case you go low.
I set up a sec basal for the amount of time i am on the med plus a couple of days after for it to get out of my system it seems to work for me but I have to play with the dosage for the first day.
Thanks for all of your replies - Have tweaked the basals with my NP’s help, as well as slightly increasing I:C ratios at lunch and dinner as I was going quite high for me after meals. The basals were definitely helping the fasting and inbetween numbers, but the post meal spikes needed help too.
I recently started taking spinal injections for a spinal condition which has steroids but before I started I consulted with my educator and he told me how to conquer the hi’s. My pump has a feature where I can set other basals and can switch from normal to pattern a or b (I have a Medtronic 522). At first I started with using temps but that didn’t tame the hi’s so I switched to the first pattern which is a and it’s set for 2.7 and that helped. I would suggest seeing a CDE who is well versed in pump therpy and consult with them.
My CDE helped me a lot - in addition to setting temp basals, I also had to do injections though. They were worth it, as it helped control my bg readings while the steroids were in my system. Good luck!
I experimented using temp bolus rates and have found that this works for me. I am on 5mg/day, which I take in the morning. When I take it, I initiate a 190% temp basal rate for 11 hours (omnipod). During the morning and into mid afternoon, I add about 50% to what the bolus wizard recommends. I am not able to control my bg as well on Prednisone as I could before, but I am having some success. I usually am in the low 100s, with an occasional 200+ that needs a corrective bolus. What a weird drug this steroid is… RA sucks.