Sarah Howard
Sarah Howard (nee Tackett) has dedicated her career to supporting the T1D community ever since she was diagnosed with T1D while in college in May 2013. Since then, she has worked for various diabetes organizations, focusing on research, advocacy, and community-building efforts for people with T1D and their loved ones. Sarah is currently the Senior Manager of Marketing at T1D Exchange.
Sarah and her husband live in NYC with their cat Gracie. In her spare time, she enjoys doing comedy, taking dance classes, visiting art museums, and exploring different neighborhoods in NYC.
I don’t know if applying a 2% steroid cream daily for a rash made a difference or not in bg levels. It must not have been very obvious.
Does the answer depend on type of steroid? Or whether the steroid is taken orally, injected, or as cream/ointment?
One local doctor running a regenerative clinic claims that for his patients a pharmacy-compounded male sex hormone ointment (strength determined by periodic lab tests) can, in effect, increase motivation to exercise and yield other health benefits. His lab test measures hundreds of components claiming, “If you don’t test, you don’t know.” Con: $4000/year costs not covered by Medicare. Pro: He cites reputable cutting edge research published in Lancet and other medical journals where research is peer-reviewed. I have learned from his paid weekly 2-hour broadcast call-in show.
I do a temporary increased basal rate on my pump to help with elevated blood sugars while on steroids.
I have been prescribed prednisone a few times in the past. I have to double and even triple my insulin during that use.
Oral steroids significantly raised my glucose levels..
I understand that cortisone is a type of steroid. On two different occasions I had cortisone shots in my hip for bursitis and each time my blood sugar was high and very very hard to bring down for 2 days. I had been warned that this might happen; the improvement in my hip made the unconvenience worth it.
I had steroid shots for trigger finger. It raised my blood sugar for about 5 days
I was put on prednisone for about a week, last year. My blood sugars went up a lot. I had to run numerous personal profiles on my Tandem X2 pump. I ran 150%, 200%, 300% and 400%. During each day, I kept switching from one profile to another, depending upon what my blood glucose levels were. It was very mentally and physically draining. I was happy when I was taken off the prednisone.
Crazy sugars for one week after my shoulder distension arthrogram due to ‘diabetic’ frozen shoulder
I will not take prednisone. It makes controlling blood sugar impossible.
Just double or triple our insulin on those days. We add lantus to the regular pump
Very interesting. I never heard of putting Lantus into a pump. Was that something your doctor suggested?
Had steroid hip injections and had to watch BS for first few days. Also had infusions for thyroid eye disease. One of the side effects was hyperglycemia even for non diabetics but didn’t impact me at all.
I get them often for pinched nerves in my back. I have a special profile setting on my pump ( 30-40% higher)when I get injection. Steroids help my pain and raised pump profile sorta keeps my sugars in control. I definitely do more testing beyond com readings during that week.
Was given a VERY low dose by an ENT. It sent my levels up. It was a challenge to manage.
UGH – yes! What a pain. I received a cortisone injection in my shoulder many years ago. I needed about 50% more insulin to simply keep my blood sugars in the mid-to-high 100s! Even that was a battle. It was frustrating but it only lasted for about a week.
I notice none to a slight raise in sugars wvengiven Prednisone or an injection in a joint. While on oral and IV dexamethasone my sugars went through the roof. The solution my endocrinologist and I came up with that worked, was to to use R Novoline (in an injection) on the days I took it orally twice a day and on treatment day I took an injection right before they began IV bag. It seemed to keep me at a more normal sugar level, thankfully. It’s along the same plan that Stanford used when I had my brain surgery there.
My BG doubled before I even got home after a cortisone injection in my knee. I managed to stay in range by increasing my basal by 75% and doubling correction boluses for about a week. Even though the pain went away for a while, research suggests that cortisone accelerates osteoarthritis progression so I don’t think I’d do it again.
My arthritis doctor forgot to tell me about the cortisone effect. I spent 3 days trying to get my BG down and couldn’t figure out what wrong. Finally, it crossed my mind that maybe it was the cortisone injection and looked it up. About the time I found out the problem, things went back to normal.
When I resisted having a cortisone injection because I anticipated a BG problem, my sports medicine doctor told me the injection wouldn’t affect my BG unless I was “extremely sensitive”. Unfortunately, we can’t count on regular physicians to understand diabetes-specific issues.
Same for me as others, 200-300%,unresponsive to increased insulin or exercise.
Steroids that I recall: prednisone, Albutrol.
Also, Z pak (Azithromycin strong antibiotic for bad congestion) leads to similar spikes
Was around 700 for 5 days WITH massive boluses! Will never use steroids again. Ever.
While on steroids I had to add 50% to my basal insulin and then add 50 to 100% for bolus
BS up so increased insulin
I needed to take steroids for 5 days each time I did chemo. I am on Tandem x2 with CIQ so I created new profiles to use during the steroid days and the days after steroids’ were done. One profile was 2 x my normal doses of insulin.
Emphatically yes, the first time I had a cortisone shot for an orthopedic problem. I wasn’t warned, and my BG inexplicably (to me) went through the roof for a week or more, very hard to bring down. I was on the old school R/N MDI routine back then, which made it even harder to manage. I did finally get informed by my PCP (or maybe my endo?) that this was a thing, and when I reported it to the Orthopedic surgeon he was totally gobsmacked. Had no idea that could happen. Seems like a pretty common blind spot among the breed.
OTOH, much more recently I had a cortisone shot for a shoulder issue, only this time it was quite different. The ortho’s spouse was T1 and very familiar with the phenomenon. She used a formula that was supposed to minimize the BG effect, and also did it with simultaneous ultrasound scanning to guide the needle to the specific spot in question, so a much smaller amount could be administered. After my previous experience I still expected bad things but I decided to go ahead because I’m now I’m using a pump and CGM, and much better able to monitor and respond to what was happening. But instead I had very little effect at all. But it’s definitely something to watch out for and bring up with your doctor.
Would you be able to get the name of the steroid drug name that was used “to minimize” the effect? I’m due to get my next steroid shot soon.
Long ago, a cortisone shot in my knee for knee pain…followed by no way to catch my blood sugars so NEVER AGAIN!!
I should have added….IF that was the only solution for horrendous pain I am sure that with a pump and a CGM, though it would still be a challenge, it would be much more manageable today—as others have noted.
My blood sugar rises after a hour of taking my steroids
A steroid injection into my knee to ease pain and inflammation after a fall. Pre-DexCom days, finger sticks every two hours during waking hours and insulin injection for a couple of days.
I got a bad case of poison ivy twice and steroids were the only thing that helped…the poison ivy. Took a lot more insulin while on the steroids.
My blood sugars went up and had to double n even triple insulin usage.
I was prescribed steroids prior to getting T1D as an adult. I had sore joints and very tired. He did a lot of bloodwork prior. My blood sugar went up and he took me off the steroids. About a year later I was diagnosed with diabetes, T2 at first then he put me on insulin when glucophage did nothing for 6-12 months.
It’s like chasing a freight train, you really have to increase your basal rate for a few days.
Yes. I had a bad case of poison ivy and was prescribed extra strength topical hydrocortisone, early on in my diagnosis. Within an hour, I went from 90 to 175mg/dL, and kept climbing. I increased my basal rate 200% – double my normal rate – just hovered at 150mg/dL! I was so resistant.
It was a terrible time, with migraine after migraine. My sites blew out quickly (less than a day) with so much insulin. I now avoid steroids – and poison ivy – like the plague.
a cortisone shot in my elbow had no noticeable affect on blood glucose. The first time was before cgms and the 2nd, years later, was during the cgm era. Booth times the cortisone was completely effective against the pain.
More recently a 5 day course of prednisone created blood sugar havoc. I was given a progressively lower dose each day, and could watch how the effect on glucose diminished accordingly. It DID clear up my eczema. I would look into other options before repeating the experience with prednisone, but I would not rule it out.
This is my second day on steroids (Covid, chest) and have increased insulin all around by 200%…. and still run high. Our next step is 250%, then 300% if needed. The steroid is a low dose for 5 days.
True, drs don’t like to give steroids to diabetics for BG reasons. I chose to bite the bullet at the beginning instead of staying sick for 6-8 weeks like before.
Cortisone injection in my knee threw me for a loop all weekend. Glucose went up to 400 is and it took all weekend to get it down. I used many units to get it down and then it kept going up. Terrible experience I will never use it again.
YES! And, unfortunately, the doctor did not warn me ahead of time so, like someone else said, it was like chasing a runaway freight train. I should not be surprised that they did not tell me, though, as the nurse who had seen me before the doctor came in commented that it was nice that I was no longer diabetic after she saw that my latest A1c was 5.3. I had to explain to her that *yes* I was indeed diabetic as it took careful usage of exogenous insulin to achieve that A1c!
I have take Prednisone for severe respiratory issues. It definitely raised my BG and made it harder to manage my T1D within range.
Took steroid shots for severe back pain. I had to stop because my blood sugar would get as high as 600 and had to take frighteningly high amounts of insulin to wrestle it back down to just normal high.
My sugars are always elevated up to high 300’s to low 400’s
I received a kidney transplant 1.5 years ago. The prednisone the dose they had me on at first raised my BG. They changed my insulin to N from glargine. I was so glad when my dose was reduced to 5 mg and I could go back to using glargine.
I could/should have steroids for shoulder arthritis, but have put it off because I know they cause problems with BGs.
Because of others, anytime my docs suggest steroid I luckily have been able to turn it down. But, I haven’t yet been in the position where it was absolutely necessary. I’m dreading the day I’ll have no choice as a path to recovery from something. I’ve heard nothing but horror story’s of extreme highs on them.
If I get a steroid injection or have had to take oral, I turn my basal rates up 150% which helps tremendously.
Oh my goodness! Yes! They injected my knee twice with steroids and both times my blood sugars remained uncontrollably high for at least a month. They also tried it to treat my trigger finger and the same thing happened. The next time I developed trigger finger in another finger, the doctor just did surgery and it worked great! But yes, steroids adversely effected my bs. It was weird though…..there was nothing predictable about it. They just stayed high no matter how much insulin I took.
That REALLY depends on which specific type(s) of steroids you’re referring to.
When I was taking prednisone, which is a glucocorticoid, yes, it DID have a noticeable impact on my blood glucose levels. It raised my blood glucose levels so high that I had to be admitted to hospital. (I was prescribed this to help with the pain and swelling that I had when I had adhesive capsulitis (frozen shoulder) in both of my shoulders at the same time. Physiotherapy served no useful purpose in my case, and steroid injections was followed up with the prednisone.)
On the other hand, I’ve been taking Fludrocortisone, which is a corticosteroid, for about 20 years now with no noticeable impact on my blood glucose levels. (I take fludrocortisone to stimulate my adrenal glands to ‘push up’ my blood pressure as I have severe ambulatory hypotension (postural hypotension). What compounds matters is that I also have hypertension (high blood pressure), for which I take Lisinopril, which lowers my blood pressure so much that I require the fludrocortisone to raise it again the next morning.)
I have taken steroids twice for Polymyalgia Rheumatica and prednisone raises my BG’s a lot, even to the 300’s. Serendipity: thanks for reminding me. Having another bout of PMR and just took the first prednisone about two hours ago!
I did not have a steroid prescription, per se. Rather, I had steroid injections as part of orthopedic treatments. They caused significant issues with my glucose management and did little to provide relief for he original orthopedic issue.
Went in for hernia surgery, BGs required higher doses to control; contacted the doc, he checked the records and IV fluid contained some steroids.
I had many steroid injections over a period of time 15-20 years ago for 5 trigger fingers and 2 carpel tunnels. All finally resolved with surgeries. In the earliest of those days (pre-pump and CGM), my BGs stayed in decent range. In later years, they were horribly high. My doctor said they were using a different manufacturer of cortisone and it was causing much higher BGs.
I’ve taken steroids before & never will again. Couldn’t get my blood sugars under 300 no matter how much I increased my insulin. Now if a Dr suggests it as treatment I just tell him I can’t take them.
Yes, Mary!!
I had my doctor list me as being allergic to them!
Same!!
Tried Flonase for sinus issues, definitely had an impact in term in increased insulin needs and difficulty bringing BGs back into range
Oh my word, yes! Significant problems with blood sugars that would not come down for love nor money… and angry feeling all the time while on them. (For a sinus infection.)
Birth control pills are steroids. My need for insulin decreased by almost half after coming off of them more than a decade ago, but I had no idea why my sensitivity increased so dramatically as it took a while for them to completely leave my system. When I recently restarted them for a short amount of time and my insulin needs increased the very same day incredibly, I understood the reason.
No, bc pills are hormones. No steroids
I made sure to look it up before hand on multiple sites to be sure they were considered steroids by everyone.
A published article of “Oral steroid contraception” from pubmed.gov states “Oral steroid contraception is a popular method of family planning worldwide. Over the past several decades, this method of contraception has changed significantly by decreasing the estrogen dose, changing the progestin component, and reducing the hormone free interval.”
They are steroid hormones. I assume we are both correct.
I had to increase my basal to 250%!
I had Bell’s Palsy and I was prescribed steroids. My blood sugar increased dramatically.
Scary Highs… never again. It was awful!
Steroids always raise my blood sugars to an out of control range – over 200 for days at a time. I usually set my basals to double my usual rate and take boluses as needed.
I’ve had steroid injections to help sports injuries a few in the last 15 years and it was as if I stopped my insulin, both MDI and pump. I’m curious if non-T1D people experience insulin sensitivity issues or whatever our T1D issue is with steroids.
#BeWell
Good question re: Do non-T1D people experience elevated BG excursions when on steroids. Curious people want to know.
Steroids had a terrible impact on blood glucose. I will always refuse steroids from now on, unless my life depends on it.
It increased my insulin needs but I don’t let my bg get high. Correct A LOT to keep it down, carry fast carbs if I overdo it (rare). I am grateful steroids are available because they work and will continue to take them when needed
Steroids raise my blood sugar significantly. I rake them as infrequently as possible and when necessary stop as soon as possible.
I had to take an extra unit during the day which for me is a lot but when done it returned to normal levels took about two weeks for an infection
I’ve received steroid injections into my cervical spine “facets” and my finger for osteoarthritis, each time within 4 hours it was like my insulin was tap water. I turn my basal rate up to 250% and need to significantly increase bolus amounts and give many extra bolus doses for about 7 days.
I had to take Prednisone orally. It raised my blood sugar considerably. 200% basals and I still had to bolus on top of that to get my blood sugar down to 250 mg/dl! I’d say that’s “noticeable!”
I stayed high (>250) the entire time
No, thank goodness! I know the likely impact prednisone (and similar steroids) would have on my blood sugar as my BG was tough to manage throughout my menstrual cycle (due to Progesterone, mainly). When I was not getting pregnant for NO MEDICALLY EXPLAINABLE REASON, the reproductive endo used a hormone to get me to ovulate which caused my BG to really go out of control. After two attempts, my husband and I decided enough and began working on adoption to save my long term health. So, I never want to have to take a steroid again!