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Asthma, Prednisone & T2 Diabetes

Anybody else here struggling with asthma and type 2 diabetes? I'm was diagnosed T2 a couple of months ago. Started drastic dietary change Oct 4th and have managed to do a really good job reversing my numbers and diabetes symptoms.

That said, I'm on my 2nd 10-day round of prednisone to control asthma/allergies in that time. Five weeks ago I was having spikes up to 250-300 which really concerned me but I didn't feel like I got good direction from either allergist or my PCP about managing glucose levels while on prednisone.

After 10 days of no spikes above 140, I'm on day 1 of prednisone again and numbers 180+ So frustrating!

 

Jenny

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Comments 21

  • Jen

    Jenny  – So you are seeing a correlation between the prednisone and spikes in blood sugar?  Have you been able to speak to your doctors (both the one managing asthma and the one managing diabetes) to see what they might suggest?

  • Shea

    I do not have diabetes ,  but when on higher doses of prednisone , and during weaning periods, I notice symptomatically that my blood sugar gets wacky. I keep snacks in my purse and eat smaller more frequent meals. Sweateners like agave nectar are good to use for me (I put it on my rice chex with vanilla rice milk in the morning) something about it not spiking glucose levels as much. I really do not know much about diabetes. Prednisone makes me hungrier anyways so keeping things like chex mix with sunflower seeds, pretzels, and dark chocolate around, and cut up washed fruits and veggies in the fridge is helpful so you can just grab a little snack. 

  • K8sMom2002

    My dad has Type 2 Diabetes and COPD (and most likely asthma, as well, though he's never told me that), and he frequently has to go on pred during the winter. It shoots his numbers WAY up. His primary works to adjust his diabetes meds, and he has to really, really watch his diet and his blood sugar during the times he is on pred.

    It's a really bad jam to be in … you have to breathe. But you have to monitor your blood sugar as well.

    My mom also had COPD and whenever she was on a vent, they checked her blood sugar several times a day, since they were also pumping her full of steroids. I asked about the risk of high blood sugar, but it was like, "Sorry, breathing comes first."

    Have you considered asking for a referral to an endocrinologist to help balance things out? I would ask your allergist and PCP about any endocrinologists they work well with …  

    In the meantime, what if anything has helped you contain those spikes? 

  • jtomotaki

    I really haven't talked with either of my doctors about the spikes. My allergist basically said the same thing you said "Breathing comes first" and my PCP is much less concerned with spikes as long as the average remains okay. I disagree with her on that.

    Best thing I can do is be really strict low carb to avoid the spikes — but then prednisone wreaks havoc on my emotions and I have always been an emotional eater …. 

    I may need to see an endocrinologist. I haven't yet.

  • K8sMom2002

    Hmmm … pred does make many of us emotional eaters! 

    Any way you can have a pred routine? Where you have an accountability partner and/or a family member clean out the pantries (even temporarily) of your favorite treats that would spike your blood sugar?

    Also, could you ask your PCP for a referral to a registered dietitian? An RD might help you come up with some diabetes-friendly snacks that wouldn't aggravate your blood sugar while on pred?

    Another possibility … use your mind to help you … there are a couple of books out there about the unconscious cues that trigger over-eating/emotional eating. Brian Wansink is a scientist who's studied the things that make us eat more. 

    He has two books out:

    I haven't read the last one, but I have read the first one — and it is FASCINATING. 

    PS – if you use those links above on your laptop or desktop computer, AAFA gets a charitable donation from Amazon — at no cost to you! Plus, you can sign up with the Amazon Smile program to make AAFA your charity of choice! 

    Or if you're tight on funds, why not check your local library to see if either book is in or can be ordered through inter-library loan? 

  • Pljohns

    I'm one of the lucky ones that pred makes everything taste so terrible i actually lose weight on the stuff-and the higher the dose, the more I will drop.  it's nothing for me to drop 10-12 lbs while I'm on the 80mg dose.  Now, when I come down to 5-10, I eat everything in sight so I generally put it all back on.

  • K8sMom2002

    Lynn, isn't it amazing how that one little tablet can have SUCH a bitter taste?? 

    @jtomotaki, how are you doing on the prednisone? Still seeing spikes in your blood sugar? 

  • Pljohns

    Absolutely and makes everything taste awful-the only thing I found that tastes good with the pred is chocolate!  Plain old Hershey candy bar-every time I land in the hospital, that is the first thing DH brings me.

  • Shea

    Ooooh yes chocolate is yummy. Dark chocolate or even fondue-style on fruit and pretzels! But .. For diabetic might be better to prob get just little individual wrapped dove chocolates… The ones with the nice little messages in the wrappers… Or like low sugar oatmeal cookies with dark choc chips for the chocolate cravings.

    Hmmm… Low carbs… I think my favorite low-carb snacks/meals are: Egg salad with chips to dip into it … Quinoa-stuffed peppers … Quiches….  And.. . Maybe still rice chex with rice milk and agave nectar on top… Oh and pinwheels (deli meat and cheese rolled into a tortilla stuck together with a little light cream cheese then sliced so you can just grab one or 2).

     

     

  • K8sMom2002

    What great tips, Shea! I had a friend of mine who would wash and cut up a head of broccoli and bring it to work with her. She said she used to mindlessly stress-eat potato chips, so she swapped out the broccoli instead. I've got a dreadful habit of getting broccoli between my teeth, so I decided I'd try that with pre-washed bagged baby spinach … worked like a charm!

    Lynn, sometimes a Hershey's chocolate bar is exactly what is needed — or like Shea suggested, one tiny little inspirational Dove dark chocolate. I'm so glad your DH would bring you your best pick-me-up when you're in the hospital!

  • jtomotaki

    @K8sMom2002 this round of prednisone is killing me and it hasn't even touched my sinus inflammation this time. My prednisone-induced "I'm never gonna get better" depression kicked in and my concern for blood sugar levels went out the window and I ate whatever was easiest. Consequently glucose levels have hung around the 200-225 mark and fasting level was fairly high this morning too.

    Back on track and recommitted today …. still feeling sorry for myself though! 

     

  • K8sMom2002

    Hugs, hugs, hugs … that's a bad spot to be in. Could you ask your doc if there's anything you else you can do for the sinus inflammation? Maybe a decongestant? Or a nasal spray? Or a nasal rinse?

    I know for me. in addition to my meds, a few home comfort things can help (as always check with your doc and pharmacist):

    • straight Sudafed, the kind you actually have to talk with the pharmacist to get. I get the one without Tylenol or Ibuprofen so that I can take only what I need. 
    • straight ibuprofen or naproxen — ask your doctor what is a safe dose to take and for how long. Both of these help reduce inflammation, but they are non-steroidal.
    • warm soup —
      • my particular favorite for colds and sinus infections is hot and sour soup because the spiciness makes me feel better and more comforted — no scientific proof, just what works for me. Here's a quick and easy that's easily tweakable (can't remember your food allergy avoids) and you can use whatever mushrooms and garlic and ginger you have on hand. (I leave out the tofu and the sesame oil and I use potato starch instead of cornstarch). And instead of using Sriracha, which I never seem to have on hand, you can use Chinese/Asian chili sauce or any other hot sauce or hot mustard. I'd bet you could even up the thickener and leave out the eggs.  
      • Any hot soup that you like and is safe for you might also make you feel better — there's a reason colds seem to call for chicken soup!
    • hot tea — I like regular hot tea, but I've also done ginger tea and lemon tea and peppermint tea. 
    • menthol vapor rub (ask your doc about this first because sometimes it can aggravate people's asthma). 
    • a heating pad on my face — I'll put it on low and lie down with one side of my face for a bit, and then rotate and do the other side. 
  • jtomotaki

    Thanks, Cynthia! I use flonase and have been taking regular sudafed and mucinex (Like you, I prefer to take exactly what I need instead of the combo meds!). Dr prescribed Dymista – I tried it for about 5 days but could not tolerate it at all. Nasal rinses are next I guess. I would love to go home (instead of suffer through this workday!) and have someone fix me a nice bowl of soup. And bring it to me while I sit on the couch with a blanket and a pillow in front of the fireplace with the Christmas tree lights on and watching a good show ….  Really I think I just want to be a little kid and have my mom take care of me for a few days!!! This adulting stuff is too hard. 

  • K8sMom2002
    jtomotaki posted:

    I would love to go home (instead of suffer through this workday!) and have someone fix me a nice bowl of soup. And bring it to me while I sit on the couch with a blanket and a pillow in front of the fireplace with the Christmas tree lights on and watching a good show ….  Really I think I just want to be a little kid and have my mom take care of me for a few days!!! This adulting stuff is too hard. 

    I hear ya! Any chance that you might have some soup in the crock pot at home? 

    And I hereby give you permission to go straight home from work, fix yourself something warm and soothing (even if it's out of a can), and snuggle on the sofa. Never underestimate the power of rest and a good night's sleep — and if you're having a flare, it's awfully hard to get that rest, so get it where you can.

    Were you able to tell your doctor that you couldn't tolerate the Dymista? My DD uses nasal saline spray and nasal saline gel faithfully twice a day, more if she needs it. And we have a topic called  with our faithful nasal rinsers who really swear it gives them relief.

  • jtomotaki

    No decent soups at home but I do have some hamburger meat that needs to be cooked. I'll make a keto-friendly pizza casserole that sounds good. And I will make a hot cup of tea!!!

    I called the allergist to tell them Dymista is a no-go for me. I was only able to get a response from the NP who told the nurse to tell me that I am not using it properly if I am tasting it. Whatever. It made me mad in a prednisone-induced fury I'm sure. But all my foods were tasting either like beer or very vinegar-y. AWFUL.

    I've been on prednisone enough this year to know that it was the spray, not the prednisone, that was making everything taste bad. The office gave me a sample and that was enough for me. That insurance wouldn't cover it and I didn't really want to pay $98 for a spray that I hate. NP is still convinced that I needed to give it longer to work though. 

    Twenty minutes to go ….. almost quittin' time.

     

     

  • Jen

    Jenny  – I hear you about this adulting business.  Hang in there!

  • Kathy P

    Hugs @jtomotaki - hope bg levels have been in a better range today. I hate the Prednisone mood swings! I'd also be concerned that it hasn't touched the inflammation. Have you checked in with the doc about that?

     I hate the Prednisone mood swings! I'm currently taking a low dose to deal with my current bronchitis and asthma flare. It's not too bad, but I still hate it. 

    My ds was on it for a week trying to fend off sinusitis. He goes back and forth between hangry and hyper and melancholy. I had the weirdest message exchange with him last week! 

  • jtomotaki

    @Jen I switched from Breo to Arnuity a little over two weeks ago. Why do you ask?

    Blood sugar has been better now that I've finished prednisone round. I've also read that doing a nasal rinse with saline and betadine works really well at battling/preventing chronic sinus infections. I may try that!

  • K8sMom2002

    Woo-hoo on your blood sugar being better after finishing the prednisone!

    Before you start with betadine, could you check with your doc? Our allergist overruled our former hem/onc's directive to use bacitracin or any other antibiotic in DD's nose because it killed "good" bacteria and made "bad" bacteria more prone to antibiotic resistance.

  • Jen

    Jenny – I was just checking in.   I have found that if I start using my sinus rinses as soon as I notice the stuffiness, things rarely progress into either a sinus infection or nasty cold.