[Barb d H]

I have been a Type 2 for several years. I am on 70/30 insulin. My A1c is 6.8. Neuropathy is taking over. Today I saw a doctor for my trigger thumb and wrist pain. He gave me a shot of steroids. My normal reading range is 70 to 180. This afternoon my readings went from 233 to 256. I took a fingerstick and got a reading of 339. I have paced insulin shots three times at 45 units each.
I have two appointments Tuesday to deal with neuropathy from my spine through my legs to my feet. i’m afraid it may be a problem if they order more steroids.
I need some information. Please help!

 

[itissteve]

Hi, Barb! Welcome to our community!

I'm sorry the neuropathy is causing you such grief. Unfortunately, increasing blood glucose is what steroids do (among other things). You managed this spike appropriately, by giving yourself additional insulin. However, your doctor, knowing you're diabetic, should have included blood glucose management in his/her discussions with you. It's definitely something you should discuss at your Tuesday appointments, especially since you have proof that the steroids coincided with this increase.

We're not doctors here but I would ask Tuesday's doctors a few questions:

• are there good alternative treatments for the neuropathy that do not involve steroids?
• if you choose to use the steroids, will the amounts they use be comparable to what you got yesterday?
• if you choose to use the steroids, does it make more sense to correct with short-acting insulin instead of 70/30? (I'm assuming the additional units you gave yourself were 70/30.) You may need an Rx for a little plain old insulin (though at least it should be the inexpensive kind) that they should be able to provide.

I hope others with experience in using steroids pop in to say hello and offer their experience. And I hope you stick around to share more of your experiences and questions!

 

[etherea]

I'm a Type 2 and my doctor won't give me steroids. I've only had one doctor that did and only because m A1c was under 6 at the time. I agree with itissteve that a discussion with the doctors is advised.

 

[Barb d H]

Hi, Barb! Welcome to our community!

I'm sorry the neuropathy is causing you such grief. Unfortunately, increasing blood glucose is what steroids do (among other things). You managed this spike appropriately, by giving yourself additional insulin. However, your doctor, knowing you're diabetic, should have included blood glucose management in his/her discussions with you. It's definitely something you should discuss at your Tuesday appointments, especially since you have proof that the steroids coincided with this increase.

We're not doctors here but I would ask Tuesday's doctors a few questions:

• are there good alternative treatments for the neuropathy that do not involve steroids?
• if you choose to use the steroids, will the amounts they use be comparable to what you got yesterday?
• if you choose to use the steroids, does it make more sense to correct with short-acting insulin instead of 70/30? (I'm assuming the additional units you gave yourself were 70/30.) You may need an Rx for a little plain old insulin (though at least it should be the inexpensive kind) that they should be able to provide.

I hope others with experience in using steroids pop in to say hello and offer their experience. And I hope you stick around to share more of your experiences and questions!

Thank you!
This is the first time Drs have prescribed this. I don’t like steroids and now I know why! They may have told me way back when; if so, I’d obviously forgotten. I truly appreciate your help and suggestions. I left a portal message for my Dr to remind us to discuss more in-depth.

I'm a Type 2 and my doctor won't give me steroids. I've only had one doctor that did and only because m A1c was under 6 at the time. I agree with itissteve that a discussion with the doctors is advised.

Thank you! I’ve had a few drs over the years. I think they may have assumed someone else had already gone over it. It helps a lot to hear from others about this. Especially on a weekend!

 

[mbuster]

Hi Barb, welcome to the forum.

I had a steroid shot in my shoulder a few years back. I was given a bolus insulin. I had never taken insulin before that experience. This thread was about my experience.

Several people on the forum have said they have reduced or eliminated their neuropathy by taking steps to maintain their BG under 140 at all times, some even said under 120. Just know it didn't come about overnight and it will take time to go away.

 

[Barb d H]

Hi Barb, welcome to the forum.

I had a steroid shot in my shoulder a few years back. I was given a bolus insulin. I had never taken insulin before that experience. This thread was about my experience.

Several people on the forum have said they have reduced or eliminated their neuropathy by taking steps to maintain their BG under 140 at all times, some even said under 120. Just know it didn't come about overnight and it will take time to go away.

Thank you mbuster. You brought up a lot of avenues for me to follow! I find myself jumping from one thing to another. Updating my knowledge by leaps and bounds. Recalling where I’d been before. I was initially on metformin and ended up maxing out my meter which only went to 500. That was about 10 yrs ago, again on a weekend, and in another forum. I got connected to a Britain and Australian who confirmed that no one should be on metformin. Reviewing your threads is really helpful. Thank you!

 

[Barb d H]

Hi, Barb! Welcome to our community!

I'm sorry the neuropathy is causing you such grief. Unfortunately, increasing blood glucose is what steroids do (among other things). You managed this spike appropriately, by giving yourself additional insulin. However, your doctor, knowing you're diabetic, should have included blood glucose management in his/her discussions with you. It's definitely something you should discuss at your Tuesday appointments, especially since you have proof that the steroids coincided with this increase.

We're not doctors here but I would ask Tuesday's doctors a few questions:

• are there good alternative treatments for the neuropathy that do not involve steroids?
• if you choose to use the steroids, will the amounts they use be comparable to what you got yesterday?
• if you choose to use the steroids, does it make more sense to correct with short-acting insulin instead of 70/30? (I'm assuming the additional units you gave yourself were 70/30.) You may need an Rx for a little plain old insulin (though at least it should be the inexpensive kind) that they should be able to provide.

I hope others with experience in using steroids pop in to say hello and offer their experience. And I hope you stick around to share more of your experiences and questions!

I finally got some rest! I just copied your question suggestions into a Pages document so I remember them Tuesday! I can’t tell you enough how much this helps. I’m starting to see a flicker of light in the future!

 

[itissteve]

in another forum. I got connected to a Britain and Australian who confirmed that no one should be on metformin.

Barb, did those folks go into any details on why they feel that way? I know some here prefer going with insulin over some of the other modern medications, but metformin has a long history of acceptability and minimal long-term side effects.

 

[mbuster]

Thank you mbuster. You brought up a lot of avenues for me to follow! I find myself jumping from one thing to another. Updating my knowledge by leaps and bounds. Recalling where I’d been before. I was initially on metformin and ended up maxing out my meter which only went to 500. That was about 10 yrs ago, again on a weekend, and in another forum. I got connected to a Britain and Australian who confirmed that no one should be on metformin. Reviewing your threads is really helpful. Thank you!

I've got to ask what is your diet like? Could you share with us what a typical breakfast, lunch, and dinner is like for you?

Has anyone discussed the advantages of eating a low carb diet? Carbs - starches, sugars, and some fibers - in the foods we eat turns to glucose and is the major source of what makes our BG go up. We can manage it with lifestyle changes (what we eat and physical activity) and/or medications. The recommendations given 10 years ago were dead set against low carb diets, they said it won't work, can't be sustained, and meds were the preferred treatments. Slowly over time, the low carb way of eating is finally being given some recognition as beneficial in controlling BG by the diabetes associations. They are not yet giving a full fledge recommendation, but it has been a big achievement just getting honorable mention.

I was going to ask about the metformin confirmation as well, but itissteve's post covered the bases of that question for me.

 

[Barb d H]

Barb, did those folks go into any details on why they feel that way? I know some here prefer going with insulin over some of the other modern medications, but metformin has a long history of acceptability and minimal long-term side effects.

itissteve, It was a long time ago but there were a lot of people all over the world who had numerous similar problems with metformin. In general, it was upsetting their systems and not very effective. With me, my body just did not feel right. It seemed to me that it’s long history of acceptance was by doctors not diabetics. All I know is that I felt better once I stopped taking it.

 

[Barb d H]

I've got to ask what is your diet like? Could you share with us what a typical breakfast, lunch, and dinner is like for you?

Has anyone discussed the advantages of eating a low carb diet? Carbs - starches, sugars, and some fibers - in the foods we eat turns to glucose and is the major source of what makes our BG go up. We can manage it with lifestyle changes (what we eat and physical activity) and/or medications. The recommendations given 10 years ago were dead set against low carb diets, they said it won't work, can't be sustained, and meds were the preferred treatments. Slowly over time, the low carb way of eating is finally being given some recognition as beneficial in controlling BG by the diabetes associations. They are not yet giving a full fledge recommendation, but it has been a big achievement just getting honorable mention.

I was going to ask about the metformin confirmation as well, but itissteve's post covered the bases of that question for me.

mbuster, when I was finally diagnosed, I received training from a hospital program on diets. I got all kinds of books, pamphlets, recipe books and info on carb control. I immediately started the “1/2 and 2 quarters” plate system as well as controlling my carbs.
My typical breakfast consists of two eggs, basted with water, in a Teflon type skillet that requires no oil/butter; sometimes an egg and veggie omelette prepared in a microwave. I’ve given up on cereals (including oatmeal) except when my BG goes really low (60s and 50s). Lunch is light with protein (turkey, chicken, fish) and a slice of bread with an occasional fruit. Dinner is protein with 1 or 2 vegetables and some fruit; sometimes just a salad with tomatoes, nuts and a little cheese. Snacks are usually blueberries with a little cream, or if BG is down a small candy bar or some dark chocolate; maybe half a banana with peanut butter.
I know when I’m sick or stressed, BG goes crazy.
Food has been a problem as my husband is a meat/potatoes/gravy guy but he’s come around and it doesn’t bother me to fix two separate meals or get him to like mine. Preparation has been delightful since our kids got us an air fryer!
However I must confess I occasionally break all the rules and indulge a bit.
I’ve also been on some insulin pens until it got too expensive. I get my Novolin 70/30 at Walmart at about $24/vial.

 

[Barb d H]

mbuster, when I was finally diagnosed, I received training from a hospital program on diets. I got all kinds of books, pamphlets, recipe books and info on carb control. I immediately started the “1/2 and 2 quarters” plate system as well as controlling my carbs.
My typical breakfast consists of two eggs, basted with water, in a Teflon type skillet that requires no oil/butter; sometimes an egg and veggie omelette prepared in a microwave. I’ve given up on cereals (including oatmeal) except when my BG goes really low (60s and 50s). Lunch is light with protein (turkey, chicken, fish) and a slice of bread with an occasional fruit. Dinner is protein with 1 or 2 vegetables and some fruit; sometimes just a salad with tomatoes, nuts and a little cheese. Snacks are usually blueberries with a little cream, or if BG is down a small candy bar or some dark chocolate; maybe half a banana with peanut butter.
I know when I’m sick or stressed, BG goes crazy.
Food has been a problem as my husband is a meat/potatoes/gravy guy but he’s come around and it doesn’t bother me to fix two separate meals or get him to like mine. Preparation has been delightful since our kids got us an air fryer!
However I must confess I occasionally break all the rules and indulge a bit.
I’ve also been on some insulin pens until it got too expensive. I get my Novolin 70/30 at Walmart at about $24/vial.

One thing further, in all my conversations with doctors and in my readings, I don’t recall ever hearing mention of steroids and diabetes. It’s like they all think someone else has already addressed it or they don’t think about it. I’ve definitely learned you have to be your own advocate.

 

[itissteve]

One thing further, in all my conversations with doctors and in my readings, I don’t recall ever hearing mention of steroids and diabetes. It’s like they all think someone else has already addressed it or they don’t think about it.

My experiences with doctors (both my own and those of many diabetic family members and friends) is that most of them seem to fall into two camps: the ones who are so hyperfocused on their specialty body part/system that they seem to forget things going on elsewhere can affect that part/system; and the ones who blame pretty much everything on the diabetes ("Well, you probably wouldn't have broken your arm when you fell if you didn't have diabetes."). There are some more holistically-minded practitioners out there, even in the MD/DO ranks. But I've known too many of both.

I’ve definitely learned you have to be your own advocate.

Absolutely true.

Oh, and as for metformin, yes, the gastric side effects are, unfortunately, not uncommon and some people cannot get past them (no shade; as you experienced yourself, medication can affect us all differently). I'm not quite sure how the others determined the metformin was not very effective, but, as you wrote, it was a long time ago and I'm sure it would be difficult to reconstruct the conversations.

 

[mbuster]

mbuster, when I was finally diagnosed, I received training from a hospital program on diets. I got all kinds of books, pamphlets, recipe books and info on carb control. I immediately started the “1/2 and 2 quarters” plate system as well as controlling my carbs.
My typical breakfast consists of two eggs, basted with water, in a Teflon type skillet that requires no oil/butter; sometimes an egg and veggie omelette prepared in a microwave. I’ve given up on cereals (including oatmeal) except when my BG goes really low (60s and 50s). Lunch is light with protein (turkey, chicken, fish) and a slice of bread with an occasional fruit. Dinner is protein with 1 or 2 vegetables and some fruit; sometimes just a salad with tomatoes, nuts and a little cheese. Snacks are usually blueberries with a little cream, or if BG is down a small candy bar or some dark chocolate; maybe half a banana with peanut butter.
I know when I’m sick or stressed, BG goes crazy.
Food has been a problem as my husband is a meat/potatoes/gravy guy but he’s come around and it doesn’t bother me to fix two separate meals or get him to like mine. Preparation has been delightful since our kids got us an air fryer!
However I must confess I occasionally break all the rules and indulge a bit.
I’ve also been on some insulin pens until it got too expensive. I get my Novolin 70/30 at Walmart at about $24/vial.

Your diet is not as bad as I thought it would be carb wise. I tried the ADA recommended diet, the low glycemic index diet, pescatarian diet, and even an almost vegan diet, none of them worked on controlling my BG at safe levels. A low carb/keto diet is the only one that let my BG levels drop down into non-dangerous levels (under 140) with any consistency. Since I try to keep my carbs low, I don't shy away from saturated fats (butter, lard, heavy cream, olive oil, avocado oil, etc). I do stay away from vegetable and polyunsaturated oils (too much omega 6 is bad). Berries are about the only fruits I eat, but occasionally will do small pieces of melon. I try to avoid anything starchy unless I can retrograde the starch in it (process of making some starches resistant to digestion). I don't eating anything claiming reduced fat, low fat, light or that claims to be diabetic friendly if I can avoid it.

I don't break all the rules, but I do stray too much at times, way more often now than I used to. My big weakness is mixed nuts and keto friendly deserts and candies. The nuts and good, I just overindulge on them. As far as sweets, I need to go back to just 85%+ Cacao bars. I thought 90 and 95% cacao were not sweet at all until the first time I ate some 100% cacao. Now I can easily taste the sweet in 95% .

Your husband is as lucky as I am. My wife, referred to as BH (better half) usually fixes separate meals, she is not diabetic. She has converted to eating more of the things she fixes for me after tasting them and finding out first hand how good most of them are. For those carby things that are "oh so good" but haven't found a good substitute for, it's easy to avoid when I ask myself "Do you like that hot fudge sundae better than your toes, kidneys, and eye sight?" the answer is always "No I don't."

Hopefully they will get the insulin costs down where it is affordable to be able to use basal and bolus doses. The 70/30 mix of basal and bolus insulins sounds more convenient, but probably isn't the best choice for the right amount at the right time for the best coverage.

 

[Barb d H]

Your diet is not as bad as I thought it would be carb wise. I tried the ADA recommended diet, the low glycemic index diet, pescatarian diet, and even an almost vegan diet, none of them worked on controlling my BG at safe levels. A low carb/keto diet is the only one that let my BG levels drop down into non-dangerous levels (under 140) with any consistency. Since I try to keep my carbs low, I don't shy away from saturated fats (butter, lard, heavy cream, olive oil, avocado oil, etc). I do stay away from vegetable and polyunsaturated oils (too much omega 6 is bad). Berries are about the only fruits I eat, but occasionally will do small pieces of melon. I try to avoid anything starchy unless I can retrograde the starch in it (process of making some starches resistant to digestion). I don't eating anything claiming reduced fat, low fat, light or that claims to be diabetic friendly if I can avoid it.

I don't break all the rules, but I do stray too much at times, way more often now than I used to. My big weakness is mixed nuts and keto friendly deserts and candies. The nuts and good, I just overindulge on them. As far as sweets, I need to go back to just 85%+ Cacao bars. I thought 90 and 95% cacao were not sweet at all until the first time I ate some 100% cacao. Now I can easily taste the sweet in 95% .

Your husband is as lucky as I am. My wife, referred to as BH (better half) usually fixes separate meals, she is not diabetic. She has converted to eating more of the things she fixes for me after tasting them and finding out first hand how good most of them are. For those carby things that are "oh so good" but haven't found a good substitute for, it's easy to avoid when I ask myself "Do you like that hot fudge sundae better than your toes, kidneys, and eye sight?" the answer is always "No I don't."

Hopefully they will get the insulin costs down where it is affordable to be able to use basal and bolus doses. The 70/30 mix of basal and bolus insulins sounds more convenient, but probably isn't the best choice for the right amount at the right time for the best coverage.

Love your comments! I try to follow low carb with the glycemic index. I asked a former Dr about keto and she emphatically said NO without explanation. I follow intermittent fasting, which I like, which has ended up being ‘eat something healthy when I’m actually hungry (sometimes triggered by low BG)’.

I’m confused about your saturated fat note. For my heart disease issues, I try (and fail) to avoid them. Now my “pre-diabetic’ daughter suggested them. (Her Dr is T1.) So I use a little half and half or cream to calm reflux.

One cure for my low BG: I keep candy orange slices (2 = 23 carbs) or an Atkins double fudge brownie bar (18 carbs) beside my bed for when my sensor wakes me up.

I’m definitely going to borrow your choice question! Hot fudge sundaes with nuts are a weakness for me. Now I have a choice between sundaes and organs! Thanks!

After having an MRG, yesterday I saw two new Drs. One for impingements from spine to toes; one for diabetic neuropathy. The first said my problems are probably not impingement. The second is sending me to physical therapy (PT) and pain management (PM). Fortunately the MRG noted some nerves are trying to do re-routes! The body is as amazing as it is frustrating!

I agree with your observation on 70/30 vs fast acting and will keep the fast acting around for those unanticipated 200+ highs.

Thank you!

 

[Barb d H]

Another thing I learned yesterday to my amazement is that diabetic neuropathy could also be causing my overactive bladder and under active bowels.
If y’all haven’t guessed by now, my body is a mess!

 

[mbuster]

We are all a mess so don't feel like the lone wolf there!!!

Saturated fats have been demonized without solid evidence since the 1950s. They have used cholesterol as part of the process to do the demonizing. Most studies where the outcomes have pointed at saturated fats as being bad, turn a blind eye to the increased carbs in our diets. In fact, with the reduction of good saturated fats from our diets when the FDA changed the recommended diet to the current food pyramid of the Standard American Diet, the incidents of diabetes, obesity, heart disease, and have increased. There was a 5 part series on YouTube called The Big Fat Fiasco that talked about this. They don't seem to want to do deeper studies focusing on the results of fats vs carbs on the results.

It's my opinion that you can't eat a high fat diet and a lot of carbs or bad stuff will happen, so I cut out as much carbs as I can. I've eaten a mostly keto diet since 2012. I've seen a cardiologist every 6 months since my quad bypass surgery 7 and a half years ago and so far everything has been good. I did learn one of my bypasses had failed but I had good blood flow all thru my heart, so all was good. I've heard of rerouting of blood vessels, so that may be the amazing thing that happened with me.

I'm a bit of a conspiracy theorist and believe a lot what is done health-wise, by the health industries or other entities is not so much for the betterment our health as it is for their pocket books. They don't make near as much for all of us to be healthy.

 

[Barb d H]

We are all a mess so don't feel like the lone wolf there!!!

Saturated fats have been demonized without solid evidence since the 1950s. They have used cholesterol as part of the process to do the demonizing. Most studies where the outcomes have pointed at saturated fats as being bad, turn a blind eye to the increased carbs in our diets. In fact, with the reduction of good saturated fats from our diets when the FDA changed the recommended diet to the current food pyramid of the Standard American Diet, the incidents of diabetes, obesity, heart disease, and have increased. There was a 5 part series on YouTube called The Big Fat Fiasco that talked about this. They don't seem to want to do deeper studies focusing on the results of fats vs carbs on the results.

It's my opinion that you can't eat a high fat diet and a lot of carbs or bad stuff will happen, so I cut out as much carbs as I can. I've eaten a mostly keto diet since 2012. I've seen a cardiologist every 6 months since my quad bypass surgery 7 and a half years ago and so far everything has been good. I did learn one of my bypasses had failed but I had good blood flow all thru my heart, so all was good. I've heard of rerouting of blood vessels, so that may be the amazing thing that happened with me.

I'm a bit of a conspiracy theorist and believe a lot what is done health-wise, by the health industries or other entities is not so much for the betterment our health as it is for their pocket books. They don't make near as much for all of us to be healthy.

Congratulations on your quad! My Bill went in for a knee replacement. Leaving the hospital, he had a heart attack. Five and a half hours later, after several bad problems on the table and a quad, he was known as the miracle in ICU242! He was fortunate in that one artery had started to reroute which kept him going as long as it did. He had problems in that what he needed to do for his knee was the opposite of what he needed to do for his heart! That was in 2017. God has been good to us!

I’m really getting angrier about Pharma and agree they’re lining their pockets. My spine Dr asked me about my insulin and cringed when I said I use the ‘dog’ insulin at Walmart because it’s only about $24/vial and don’t need a script. I’ll be talking with my primary next week about all my meds. We both have several Rxs that eat up a good portion of our SSI. We worked and saved hard only to have most of it taken away. Between health industries, insurers and government, the golden years are getting tarnished

With everything that’s happened this week, I seem to have fallen into a calm peacefulness that accepts a lack of appetite as normal and lacking carbs. Think I go with that for awhile.