National Diabetes Month – November 2002

Nearly 17 million Americans are affected by diabetes, a chronic disease that interferes with the body’s ability to process sugars normally. 

Hi, my name is Doris and, as I write this on November 4, 2002, I am just returning to the office after being in and out for about two weeks.  I am a diabetic, diagnosed about 6 years ago and as with most sufferers, I have my good days and my bad days.  I’d say for the first four years, I was borderline and kept my sugar in a normal range with the help of oral medications.  The last two years have been a different story.  With no real symptoms or after effects, I became like a kid and began to cheat – a candy here, a cake there.  And up until about two weeks ago, I almost got away with it, or so I thought.

It was a Sunday evening at about 10:30 p.m. and I was checking my sugar before bedtime.   I had spent the previous week battling to recover my breathing capability due to a severe bout of bronchial asthma – an ailment I’m prone to because of my diabetes and congestive heart failure history.  Almost over the asthmatic spasms, I was feeling good, had energy and was looking forward to the weekend.  My family and I had a great Chinese meal and spent the evening playing cards.  And then POW, it hit me.  When my blood testing meter beeped instead of a number I saw the word “HI”.  Was I losing it?   In six years I never saw that message.   Of course, I couldn’t find my book to look it up, so I called the 800 number on the back of the monitor and thank goodness they have someone there to answer calls, even at midnight on a Friday night.

Can you imagine my surprise or should I say horror at learning the message meant my blood sugar was in the 600 – 800 range!  Okay.   So after the heart palpitations subsided, this wonderful customer service rep calmed me down, confirmed an accurate machine reading and gave me advise on what to do.  So, for the next two hours, I watched my sugar readings say “HI”, “HI”, “HI” and finally 501.  Down they were coming.

WHAT IN THE WORLD HAPPENED?

 STEROIDS!

Some of you may know what I’m talking about and some may not.  I didn’t.  I had heard about steroid abuse but I never connected medical use of steroids with adverse effects on diabetics.   Steroid treatment is often used to treat many conditions including asthma, chronic lung disease, skin conditions and allergic reactions such as poison ivy.  For three days, I was taking nebulizer treatments and getting steroid shots.  Upon reflection, I know my doctor told me that my sugar might rise and it did, but I never imagined it would become severe.  The treatments worked and my bronchial asthma was cured.   However, my sugars were erratic and my poor diet control added fuel to the fire.

For the next three – four days, I bounced from readings like 90 to 420 in a single day.  My doctor and I finally found the proper balance of medicine and my sugars came down.  This morning when I woke up, I was glad to see that familiar # 90.  I am back on my program of healthy foods, moderate exercise, and medication.  Thanks to careful monitoring and control of diet, I am feeling better and I am better educated about steroids and diabetes.

I thought of you out there and wanted to share my experience, so maybe you can avoid a hyperglycemic episode like mine.  Here’s what I know about steroids and diabetes and here’s how you can find out more on your own.

 Medical use of steroids:

Steroids are either taken in pill form, by injection into the muscle, as a topical cream or nasal inhalation.  Small doses of steroids are used by doctors to treat asthma, chronic lung disease, arthritis, many skin conditions and some allergic reactions.  Other uses include treating some forms of anemia, some breast cancers, osteoporosis, endometriosis and a swelling disorder called angiodema.

It is a known fact that blood sugar will go up after starting steroid medications.   While taking steroids, it is important that you and your doctor adjust your insulin or oral medications to meet the changes that will occur to your metabolism.  The good news is that once steroid treatment is concluded, you sugar levels will return to normal in a few days.

 Remember these key points, if you have to take steroid medications:

• Be aware that your sugar will rise during steroid treatment
• Work with your doctor to adjust your medications during and after treatment to avoid sugar highs and lows
• Check your blood sugar more frequently during steroid treatments
• Keep your doctor informed about severe reactions
• Be sure to stick to your food program to keep your sugar low
• Check with your doctor about exercising when your sugar levels are above 250.  Exercise can sometimes raise your sugar levels.

For a free fact sheet on Steroid Abuse, please visit:  file:///W:/acde.org/common/Steroids.htm

Here are other good sites to visit fore more information about diabetes and steroids:

The Diabetes Monitor Home – www.diabetesmonitor.com/steroids

American Diabetes Association - www.diabetes.org