Will I recover my presteroid blood sugar levels aftre having stopped steroids

Hi and welcome to HealingWell. I was on the tapered dose pack of prednisone for hip bursitis twice in the past and my blood sugar went back to my normal after about 10 days, or maybe two weeks. According to what I've read, that recovery time depends on how long a person is on the steroid and what the dose is. And, I think it may vary with the person and what the person is eating.

It's really disheartening to deal with this when you've been controlling your blood sugar. There are cases in which the blood sugar hasn't returned to its pre-steroid levels.

I hope it's just taking time to leave your system and that you don't have any permanent effects. You might ask your pharmacist for a more complete answer. I'm sorry I can't help more.

Hi again. Yes, I am a type 2 diabetic (see my signature?) and I've had bursitis a few times, triggered for a couple of reasons. The last time I was on pred was about a year ago. The doctor has always warned that my blood sugar would spike - and it sure does - but it always went down to my normal.

Stopping any steroid abruptly should not be done. You are supposed to taper off the medication which is always in the dosage directions.

Since it's well-known that steroids raise blood sugar, doctors frequently prescribe diabetes medication when the patients have to be on the steroids for long periods of time.

I'm going through something very similar. I was prescribed prednisone in the attempt to help reduce inflammation in the bile ducts in my liver. My sugar levels probably spiked immediately, but I didn't receive treatment for two months because I didn't know there was anything serious going on. I actually went into the ER with a blood sugar level of "699 mg/dl" seeking treatment for a cough, thought of a oral infection, and doctors request for a blood lab due to "blurry vision".

I'm not pre-diabetic or anything (that I know of), but by what I understand sugar levels "generally" return to normal after the steroids are cleared from the system. Now I mean cleared from the system... by what I understand some peoples bodies are even happy when the steroids are just reduced, some are happy right when the steroids end, some take a few weeks, less need months, even less more need than a year to recover, and some don't recover/develop diabetes. But for the most part you can expect things to go back to normal.

The problems with these steroids is that they make the whole body resistant to insulin. So all your cells have a harder time using insulin and keeps your blood sugar up when they rise. At the same time your liver doesn't really "see" the insulin in your blood either, so it becomes kinda confused. At that point your liver decides there's probably not enough sugar in the blood for the pancreas to have a reason to put out some insulin, so it makes some sugar and pushes it out trying to equalize everything.

Try to not stress or worry about it, a raise in blood sugar is VERY common with these steroids.

May have some interest in looking at these

http://dtc.ucsf.edu/types-of-diabetes/type1/understanding-type-1-diabetes/how-the-body-processes-sugar/the-liver-blood-sugar/

For this one note "Characterization of hyperglycemia"
http://www.dmsjournal.com/content/5/1/18

I must thank Lanie & EPhantom for their prompt responses. I felt very reassured by EPhantom’s comments which he painstakingly wrote down for me. They were very comforting and encouraging. Otherwise I was very much broken down mentally.

I too must tell you both some reassuring news. I had now bought a new glucometer (I never had one all these days. I used to check my sugars in lab - venous FBS once in six months).  I checked my capillary FBS after overnight 10 hours fasting.  The result is 113mg/dl.

One should not go only by one reading so I make a qualified statement that seems that sugar levels have appeared to drop.  In my assessment from going through my reports I had worked out Glipizide 2.5mg drops my sugar by 10mg/dl and 5mg drops by 20mg/dl.

So I could say with caution that if I convert to a blood sugar without glipizide and only due to pioglitazone 45mg which was what I was taking before the reading would have been 113 + 20 = 133mg/dl.  This is compared to 157mg/dl which was when I did with only pioglitazone 45mg on 08^th August.  We cannot go by only one reading and I hope to do similar readings about twice a week.  But I could say I have reasons to believe there is good hope. 

My FBS just prior to steroid therapy was 121.5mg/dl. If so reading should come down still lower to match pre-steroid levels, but I could be hopeful of reaching it with today’s result.

Thanks again so much

Lanie, I was carefree and did not bother too much. However I avoided sugars as far as possible. I did not eat ice cream but did everything else.  I ate starch as rice and curry is our staple diet in the Indian subcontinent.  Still my sugars were controlled and HB1AC was 6.   I know it is amazing.  My medication was as I already told pioglitazone 45mg.

I never had a glucometer only bought one yesterday.   Before, I checked blood sugars (with other blood tests) every six months.  As told blood sugars were generally within 90-120mg/dl range.  HBA1C was 6. 

It is the scare after the steroid fiasco I got very upset and I just bought a glucometer (Accu-Chek Active) so I could properly monitor the progress.

 Lanie, I am aware carbohydrates or starch is sugar.  I am non vegetarian. I do take vegetables.  But other than avoiding pure sweets, I do not or rather lazy to be picky, so eat what is served sort of.   I have three normal meals but do have snacks in between like anyone else.   

 

Since my FBS was till now within acceptable range in spite of my carefree state.  So thinking my pioglitazone will take care of my ills and I do not curtail my freedom.  May be not everyone can survive my rules or rulelessness.  

Lanie, I had what is called anterior capsulitis. As you know I had other forms of treatment and it did not work. Actually the condition did not bother me and was never incapacitated. It was quite mild.  I tried the prednisolone therapy   in the dose I already mentioned. I knew sugars will go up but never bargained the levels they shot up.  It was my wife who noticed ants crawling in the commode and cautioned me which then stuck a code  and I checked the urine and bloods and realized sugars were  high.  FBS was 222.8mg/dl. 

By then two weeks had elapsed and I was very scared never bargained sugars to shoot so much.  I then decided to give up treatment as my diabetes was far more important.   That is why I call it a ‘steroid fiasco’.  So it was a futile exercise placing high risks and I blamed myself for it.  I know the natural history of the capsulitis is such   they will cure naturally anyway, but takes its time. Treatment might expedite the cure that is all.

Naturally I had to confess to my endocrinologist and he warned me never do such things without proper expert advice and help.  So shoulder is little better due to the steroid but not complete. I had to complete a 4 week tapering course of steroids which I did only two weeks and gave up.

Lanie

The lesson I learnt is that steroids are not safe to play with. Unless used for a few days in low dose such as resistant asthma (which I have done). Otherwise best avoid unless you cannot help. If so must be taken monitored by a doctor experienced in such situations.  

Were any X-rays taken on your  hips and a bony lesion of the joints excluded? Which bursa did your doctor say is affected?

Lanie

 The common type of bursitis in the hip is the trochanteric bursitis and most likely that is what you have. It is on the lateral side of the hip which one can feel as a bony prominence and it is called the greater trochanter. 

Conservative measures are first tried and then steroids are injected located by feeling the maximum tender spot. Actually steroid is mixed with local anesthetic agent so that one will get an immediate response from the anesthetic and also will be a therapeutic confirmation injection was given to the correct spot.  If there was only a poor response   then possibly the injection was not given to the correct spot  because the anesthetic agent should anesthetize  and numb the local spot and one should get relief at least until the anesthetic wears out and should be able to perform movements  pain-free  due to  anesthesia  effect  which otherwise would have caused pain.

You can also Google ‘bursitis of the hip’.

http://my.clevelandclinic.org/disorders/bursitis/hic_trochanteric_bursitis.aspx

http://orthopedics.about.com/cs/hipsurgery/a/hipbursitis_2.htm

 

I did another FBS today (21^st August) using my glucometer and the readout was 116mg/dl. On the 18^th was 113mg/dl. I could say rather maintaining it is new level.  On the 31^st July the FBS, done in the lab using venous blood with the same drugs the reading was 138mg/dl.  Assuming there is no difference between the two methods of testing I could say there is reduction of blood sugar of about 20 units over the past 18 days.

I have estimated that each 5mg glipizide drops sugar of about 20 units.  So this reading will amount to 136mg/dl, if estimated for if taking only my previous drug pioglitazone 45mg.  My pre-steroid FBS level done a month prior was 121.5mg/dl. So I still need a reduction of another at least 10units to say I have recovered fully after the steroid therapy.

Thanks for reading.  

Post Edited (ShanShri) : 8/21/2014 5:05:29 AM (GMT-6)

Lanie, you said: I hope that your fasting blood sugar comes down too. The figures I mentioned 113mg/dl (18 th August) and 116mg/dl (21 st August) are my fasting blood sugar results taken from my new glucometer. My goal and wish is regaining my pre-steroid levels of blood sugar control, so that I did not suffer permanent damage of my foolish move to use steroids.   May be temporarily to use glipizide to clear the mess, but ultimately I want to get back to what I was before without glipizide and purely on pioglitazone 45mg with the degree of control I had before. Otherwise I will not be able pardon me.

Lanie, Sure agreed!