Steroids and pump adjustments

I have to do 10 day steroid packet. I began on Wed. Have made adjustments but since this is my first experience with this situation, it is a trial and error. I seem to be staying higher the first 12 or so hours after meds then it begins to settle a bit. Does anyone know if it’s just varied person to person or any advice out there from my support? Sure with there was a formula.

I don’t think there is a formula other than keeping a really close eye on your BG. When I took steroids I spent days at 200% basal rate. My endo said he’s seen people who have to go to 300%. Just be really careful when you stop taking them to check your BG really frequently so you can adjust for drops.

Good luck - hope the steroids help!

I did 200% a couple of years ago and it worked pretty well. I just guessed and was sort of suprised by how smoothly it worked? I hope that you can figure it out!

Thanks so very much. That is two of you with the 200% so that helps. I am not doing enough and so am staying up all night fighting with it and trying various correction doses. I did change my basal but obviously not nearly enough. I had no idea it was so much of an increase and have only pumped 2 yrs. I appreciate the help from this site and it’s great and caring people so much and the steroids are helping so much with whatever this is in my wrists. Still feel a bit funky but can use my hands again!

I very much appreciate the help. That is two people who have used this 200% - maybe that is the secret. As I commented above, I had no idea it would be that much. Thanks for the response.

My daughter is on inhaled steroids now and a bronchodilator for asthma flare up and both meds cause BG elevation I was told to go as high as 200% if we have to as thats what most people have to do. We went up 100% on basal and still have fairly uneven BG. Sometimes they are like 170 which I could live with while she is sick , some times they are 320 which is way too high. Lots of trial and error. Got it under control now , but took us 4 days. Also my endo said when you up your basal that much dont forget to up your correction factor also so you are giving more insulin to correct when needed… Feel better

Thanks so much for all the information. It seems the general thing to do is 200%. I will try the first 100% then go slowly as I don’t want a bad low but at least that is a guideline. My BG had been running lower this last two months so that gave me a better base. At least I was not at one of my high times. I hope your daughter can outgrow the asthma. I know that can be difficult with a child. Thanks for the reply.

I also was placed on a high dose pack of steriods to help relieve laryngitis(sp?). I thought increasing my basal to 50% was enough, but, obviously that hasn't helped! I didn't go as high as everyone has suggested on my basal rate due to the fact
that I do not check my BS other than in the AM. I will certainly give it a try, though. Thanks for the help!

I wanted to let everyone know that my BS was extremely high this AM, so, I took some of your advice. I am increasing my basal to 200% & checking my BS to see how if affects it. I will hope for the best!

If you go that high with your basal it is essential to check your BG much more often than in the AM. I have not had to go to 200% with mine. I take my steroid with dinner and by morning the effects are gone for me. I had been running low prior to the steroids and after the meds wear off a few hours i go back to the lows I was running before starting the meds. That must mean everyone is different and with me they just don't last that long. I've used 2 or 3 30% basal increases for an hour or 1/2 hr at night after the meds until my BG is back down or heading down . That usually gets me to at least 175 and going down and even if still a bit high when I go to bed, it is down by morning. There is no way I could have done a 200%. Please watch your BG closely. We are all different and you took a large jump. I had changed my basal and a couple of other settings and have now found that just using Temp Basals is the best and have put settings back to normal. I have an Animas Ping and can set my Temp Basals for whatever length of time and for percent. That has just worked the best for me. If you set your regular 24 hr basal for 200%, you can get yourself into trouble.

Hi Karla,
I'm a type 1 diabetic, and I have had both a heart, and kidney transplant. I need to take steroids every other day for my kidney transplant. I had the hardest time controlling my BG's on days I took steroids before I started on my insulin pump. As a general rule I need almost a 100% more insulin on days I take steroids, and 100% more basal insulin too, as steroids cause insulin resistance. A lot of it is trial and errors in the beginning. For starters you could try lowering your carb ratios slowly, and try lowering the sensitivity, and you can increase your basal rate too. This can all be set up under bolus, and then bolus setup, and the bolus wizard, edit settings, if you use a Medtronic insulin pump? If you use another type of pump I may not be of much help as I have only used Medtronic pumps.

Best of luck,
-Aaron

P.S. These are just some suggestions, be sure to check with your doctor before making any changes. I'm not a medical professional. I'm just speaking from my own experience.
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Thanks Aaron, and I'm so sorry for all you have had to endure. You'd think diabetes would be enough! I use an Animas Ping but I actually did all you suggested on the first day I took the steroids. With me, I have to tweak the I:C and the ISF for things like this. I learned that the hard way. I only seem to stay high for about 12 hr following the med dose which I take with dinner. By morning, I am getting back to normal. At night, when my BG is at it's highest after the med, I am also using temp basals to get the BG down and have only had to use 30 - 40% for an hour at a time and depending on the size of steroid dose, I do that for an hour - 2 hrs. I also do correction dose if necessary so all of it together has managed to keep it down. I heard this morning that I'm being sent to specialist as my SED rate was high so whatever caused my problem is systemic. I suppose that probably means this is not my last experience with steroids. However, they have made me feel so much better. If you can deal with it, so can I! Thanks for the reply and I appreciate you and everyone here who share their experience and how they managed it. I sure wish you luck with your journey and am sorry you have had to go through so much.

I did reset my temp basal to be only 100% greater because I had a low this AM. I think I understand now what to do. Thanks!

Please be careful and maybe try a 20% - 50% for a few hours as you still took a large increase in basal. This is a dangerous thing you are messing with and as I said yesterday, we are all different. While 3 nice people on here shared their use of 200% increase as per their Endos, that would have killed me or at least required intervention. When I began, I did what we all are suppose to do and started slowly. It is much easier to deal with being too high than being extremely low. I understand you are already using the 100% but IMHO, a 50% max would have been better to start if not even lower. You can then do another increase if that is not enough. As with me, I found that 40% was the max for me and only for a few short hours. That is why I went to the TEMP Basal and not completely change my basal. I only needed the increase a few hours and not for 24 hours. Just watch your BG closely and I wish you good luck. Take care.

I don't think I made myself very clear when I said I increased my basal by 200%. I meant to say that I did a TEMP basal at that rate & have now gone to a 100% TEMP basal for only 4 hrs at a time. Sorry to concern you. This AM, I had to decrease the TEMP basal to 50% for 4 hrs, due to a low.