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Diabetes

High blood surgars early mornings

04/08/2008

Question:

I`ve been a type 1 diabetic for 54 years with success in controlling blood sugars. I just finished 12 days of prednisone theapy for asthma problems and a visit to ICU for food poisioning. I`m doing 3 daily nebulizer treatments of ibuteral and 250 & 500 strength Advair. My blood sugars during the day are normal/under controll. At night though the go from 100 at bed time to 280 by morning. Do you have any suggestions?

Answer:

I don't know enough about your individual situation to go into specifics but we do commonly need to adjust a diabetes regimen for patients with diabetes who go on steroids temporarily for another disease process, with the plan to stop that adjustment when the steroid treatment stops.  People vary quite widely in how much of a dose adjustment they need and how long they need it, both because of differences in the steroid regimen as well as differences in the response to the steroids.  It is commonly helpful  to do an increased frequency of blood sugar testing to guide those decisions, as the onset and offset of steroid effect can be quite abrupt.  If you are on insulin, and the effect is just during a certain portion of the day, it will also be important to decide which portion of the insulin regimen to adjust - you may need an adjustment for a certain portion of the day but not the whole day.

Hope that helps - feel free to get back in touch with additional questions.

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Response by:

Robert M Cohen, MD Robert M Cohen, MD
Professor of Clinical Medicine
College of Medicine
University of Cincinnati