In this text, I will share my several-month experiences with various doses of corticosteroids, how I brought my blood sugar under control, and what helped me the most and the least.
Let’s start from the beginning: I’ve had type 1 diabetes for 18 years, with no complications, and my blood sugar has been well regulated. I use a pump with a smart algorithm.
I’ll briefly explain what corticosteroids are, also called "corticoids."
Natural corticosteroids are steroid hormones produced by the adrenal cortex, and for the past 70 years, they have also been artificially manufactured as a medication. In medicine, they have a wide range of uses and can be found in the form of inhalers, sprays, creams, ointments, suppositories, tablets, and injections.
For what are corticosteroids used?
They are used to suppress the immune system and reduce inflammation in a wide variety of conditions and diseases. Corticosteroids increase insulin resistance in liver cells and cells of other tissues such as fat and muscle, which is why many people experience higher blood sugar levels.
They also have a harmful effect on the beta cells of the pancreas because they contribute to a reduction in glucose uptake by cells.
Injury, rheumatoid arthritis, corticosteroids, and I
To avoid delving too much into definitions and literature, I’ll start by explaining why I needed corticosteroids in the first place. Quite unfortunately, due to a severe injury, I developed carpal tunnel inflammation, which then triggered inflammation of the median nerve in my entire arm, leading to the activation of my rheumatoid arthritis in the hand, which had been dormant until then. Anyone with rheumatoid arthritis knows the amount of pain this causes, and when that happens, anti-inflammatory medications become essential, even if they are corticosteroids.
After a few weeks, I was admitted to the emergency room and received intravenous doses of high-dose corticosteroids, which consequently led to significant insulin resistance, extremely high blood sugar levels, and despite all my knowledge and experience with diabetes, it was not easy.
I can say that at that time, I was administering insulin "like water" – huge doses with little effect on the blood sugar levels. While the inflammation was subsiding, my medical team decided that I would continue taking corticosteroids in the form of Medrol tablets for the next four months, with a gradual reduction in the dose.
Of course, I didn’t like it, but I didn’t want to risk the pain anymore, and the period of crazy blood sugars continued. My smart algorithm pump was a big help, but due to the large fluctuations, it still needed support. The support came in the form of additional medications for blood sugar regulation, in my case, it was metformin, i.e., Glucophage 1000XR, and necessary dietary adjustments.
Despite everything, blood sugar regulation was not perfect, but at least my levels didn’t go up to the catastrophic 27 mmol/L, which was incredibly exhausting for me.
With a breakfast free of carbohydrates, my blood sugars still fluctuated significantly. Even without breakfast, they reached 12 mmol/L, which was still too much for me. Such poorly regulated blood sugar further drained and exhausted me, and I was determined to find a solution.
In the end, a change in the timing of the medication saved me. I started taking the pills at night before my walk and sleep 😊 My blood sugar levels finally stabilized in the 4-5 mmol/L range, with a smooth, flat line on the graph all night long!
Side effects of corticosteroids (Medrol in my case)
It’s important to know that Medrol can be tough on the stomach, so I always took the recommended form of stomach protection.
Another unpleasant side effect is that it promotes the accumulation of fat and water, leading to an increase in body weight and an even greater need for insulin. That’s why it’s important to watch your diet. I did this by adopting a low-carb approach and investing even more energy to avoid hypoglycemia.
All these combinations were done in consultation with my general practitioner, endocrinologist, and immunologist, and I am very grateful to them for everything! 😊
Author: Mia Duvnjak
