This fall I was the sickest I’ve been as an adult. I got a wicked viral illness that turned into pneumonia which took two antibiotics to squash and I was having some wheezing and shortness of breath even after it cleared up. My doctor and I opted to do a steroid wean – an anti-inflammatory medication to reduce the inflammation in my lungs and help my breathing. Steroids are tricky with type 1 diabetes, because it changes your insulin needs greatly.
Steroids are released in the body naturally in response to stress, requiring the body to compensate by increasing insulin production to meet the new needs of the body. As a type 1 diabetic, this increase is all on you. Everyone’s body is different, and there are different steroid doses/regimens, so always talk to your doctor to see how your insulin dosing might need to change. For some additional information on steroids and diabetes, check out this article from Medtronic Diabetes.
Here is my week’s blood sugars and insulin adjustments made while on a week long prednisone taper.
Overall dosing:
- Baseline total daily dose: 35-40 units/day
- Day 1- 57 units
- Day 2- 71 units
- Day 3- 99 units (!!)
- Day 4- 70 units
- Day 5- 51 units
- Day 6- 43 units
In making my insulin adjustments, I increased all of my settings and ratios (basal rate, ISF and carb ratio) with good success. These numbers show a perfect bell curve as the steroid ramped up and then tapered down. It was crazy to me that on my third day I needed 3x my normal amount of insulin! This is important to know so that you can make increases and then realize that you will have to come back down on dosing and aggresiveness with settings as you are weaning off of the steroid. Again, everyone is different, but I hope this helps you have a place to start if you have to make insulin adjustments while on steroid medication.
