High sugar levels: Might medications be the cause?

@cocokoohlah24 Welcome to Mayo Clinic Connect. You are correct. All meds have side effects and a common one is increases in blood sugar. Your experience with therapeutic long term high dose steroids is a good example of this. Are you receiving treatment and support for your type ll diabetes?

Yes, I'm receiving help. I was finally able to get on the Dexcom 7. It had helped immensely in my having greater control over my blood sugar. I'm the first month I was able to bring my A1c from a 10.2 to a 7.8! That was big & exciting!

Congratulations on your great improvement in A1c! Can you please tell me how many points difference you usually see between your CGM sensor readings and your fingerstick readings?

@grrranny I use a Dexcom G6. (I will be inquiring about the Dexcom G7 at my endocrinology appointment next month.) The Dexcom G6 and the glucometer readings are usually quite close (within about 10 points) EXCEPT in the 24 hours after a sensor change. On the day of a sensor change I can expect SERIOUS inaccuracies. Sometimes it has lasted 24 - 72 hours! An example of this was getting a low alarm in the middle of the night telling me I was 48 but the glucometer was 139! I’ve had MANY phone calls to Dexcom customer support for this type of thing. It is frustrating because the Dexcom G6 sensor has to be changed every 10 days. That seems like too much time to have discrepancies like that! Also I use an Omnipod 5 insulin pump. The two devices “communicate”. I really dislike it when Dexcom G6 tells Omnipod 5 to put the brakes on my basal insulin delivery and I find out it is because of an invalid low. Then the next thing I know Dexcom G6 shows that I’m 300 something!

Thanks so much for your reply, Cheryl! I'm currently using the Libre 3 CGM, and it's even more "off" than your Dexcom G6 -- usually by 20-30 points, lately. In fact, it's to the point where I don't dose insulin without doing a fingerstick first. But it's not too far off in the beginning after insertion, or towards the end of the 14 day period that the sensor lasts. It's pretty predictably at least 20 points too high, so I subtract that.

I can certainly understand your frustration with the low alarms. A couple of things that have kept me from switching have been the larger size of the Dexcom, plus the 5-minute delay between readings, instead of the 1-minute readings of the Libre 3. While the new Dexcom 7 is smaller, there is still that 5-minute delay between readings that I think would make me pretty nervous if my BG were low and dropping fast. Can you tell me your thoughts on that?

On the Omnipod 5, I've been debating whether to get one to help me improve my mid-7s A1c. I've been doing multiple daily injections for the last year and a half to help manage my 26-year struggle with type 2, and I feel like a pump would help. I haven't seen an endo, but my primary care doc gave me a referral. However, I don't know if I could tolerate having a big pod like that stuck on me -- or if I could tolerate having all that adhesive, either. Am I too old at 81? Any thoughts pertaining to these concerns?

@grrranny I know this is a cliche, but age is just a number. Please don’t think you might be “too old” for something.
Regarding Dexcom vs Libre, I’ve been considering switching from Dexcom to Libre. Thank you for your information about your experience with Libre. I think I will stick with Dexcom, but look into upgrading to G7. I just had another middle of night situation last night. Last evening was a sensor change (every 10 days), a transmitter change (every 90 days) and an insulin pump pod change (every 3 days). It hardly ever happens that all 3 come due at the same time, but they did last night. When I went to bed I was a nice 82 according to Dexcom G6. An hour later Dexcom G6 alarmed that I was 63. I assumed it was a false alarm since it was a sensor change day. I got out of bed and headed to the kitchen where the glucometer is. (I noticed I had trouble walking?). By the time I got there Dexcom G6 showed 49 and the glucometer was 43. YIKES! The good news was that there was no discrepancy as I expected but the bad news was that I was truly low! In this situation I’ve been taught to consume 15 grams of carb (30 grams if the blood sugar is very low) wait 15 minutes and test again. I think the idea is to not overtreat the low causing a spike to too high, but that 15 minutes waiting seems like an eternity! Meanwhile the Dexcom G6 dropped to “low” which means less than 40 and it can’t come up with a definite number. I had chugged a glass of juice which was only 10 grams carb so I bailed on the 15 minutes waiting when I saw the “low” and snarfed 2 Tbsp of honey which was 34 grams carb according to the label. When things get that bad I try to ignore the Dexcom G6 and rely on the glucometer because it is more accurate. So I have not even noticed or been bothered by a 5 minute delay in Dexcom G6 readings. Another thing that happened was that the code for the new transmitter failed to stick and had to be reentered and paired with the sensor. In retrospect I’m not sure how the sensor worked at all given that problem.
Here is where I have to credit my Christian faith. I’ve handed my life (and body) over to God for his care and keeping. I’ve been blessed with good medical care & the latest technology, a husband to help with this stuff and probably guardian angels to protect me. It has been a 50+ year journey with diabetes (Type 1, 2 complicated pregnancies & wonderful daughters, pancreas transplant, Type 2 …). I am still here.
I’m sorry I’ve yammered on about CGM and haven’t addressed Omnipod 5. I’ve had the CGM for several years and the pump for about a year and a half. There are some technology things that I don’t get. I have heard from both companies that there changes in the works. The Dexcom G6 works with my iPhone but the Omnipod 5 does not and I have carry a separate controller. I think this is one of the changes to look forward to. The Dexcom G6 communicates with the Omnipod 5 using a mysterious algorithm to suggest appropriate mealtime and correction insulin boluses. The basal insulin is a preset rate established by endocrinologist based on blood sugar records. I trust my endocrinologist completely and wouldn’t think of using a CGM or insulin pump without her input.
The Dexcom G6 sensor isn’t that big and the G7 is even smaller. The adhesive is seriously strong! Last night with the sensor change I was having trouble getting the adhesive marks off and discovered some left over from the time before! I believe there is an adhesive remover swabs that can be purchased for help with that. The Omnipod 5 pods are about the size of a little matchbook box. They are changed every three days and come off easily. There are over patches for them and for Dexcom sensors too that can be purchased to make things more secure if wanted.
The sensor and the pod needs to be at least 3 inches apart from each other. I usually put the pod on my lower belly (below the waistline) and the sensor on my upper belly (above the waistline). I switch from right to left. I have more area to work with in the lower belly so that is where the pods go. Up top it is more bony from my ribs so I put the sensor there since it doesn’t change as often. Last night I send the Lowe belly for both, the sensor on the left and the pod on the right. They are supposed to be within a “line of sight” so I hope that works. The trainer I had for the Omnipod said that they can both be on the back of the upper arm (if your arms are big enough). I have rather big flabby upper arms so that wouldn’t be a problem but it would require assistance from someone else. I did try it once with my husband’s assistance but I like to “do it myself” as best I can.
If you think of any other questions let me know. I don’t always have answers, but I always have opinions! Have a blessed day!

@cehunt57 You are so good to answer my questions, and I really appreciate your sharing all your years of experience!
So sorry you had that bad low last night, and I hope you had a better bedtime tonight. Bad enough to have lows, but to have to deal with it at bedtime would be almost as bad as in the middle of the night! By the way, do you have a Glucogon injection kit for emergency lows? I've been wondering if it would a good idea for me to ask my doc for a prescription. Although, I'd probably have to use it on myself, due to hubby's having such severe essential tremor shaking.
I'm glad to hear the Dexcom has good adhesive, as does my Libre. I use the Unisolve adhesive remover wipes to make it a little easier to remove -- if that would help you any. It's also good to hear that the 5-minute gap between your Dexcom readings hasn't caused you any problems. I've been using the Libre for so many years, I was thinking it might be hard to get used to, but now that it's always reading so high, I'm tempted. It would be nice to have my readings on my Apple watch. too.
Did not realize that the Omnipod 5 did not work with the iPhone. I'll have to think about whether I want to carry a separate controller. So many things to consider...
Many thanks, and midsummer blessings to you!

congratulations on your huge number drop. from 10.2 - 7.8. i use Dexcom G7. it's helped a lot. but mine keeps bouncing around 7.5 - 8. but that's better than 12.6.

i get those low readings sometimes too. but my endo told me it's because i sleep on my arm. if i don't sleep on my arm, my readings are accurate.

@grrranny this is a fun conversation! I have had a Glucogon injection kit for emergencies and my husband was the one that used it on me. I think the idea is that if you can’t recognize (hypoglycemia unawareness) or treat your low, someone else can assist. I found it to be really expensive and expires after only 6 months. I decided that paying that much for something you hope you won’t need (in 6 months time) then having to get another one at that point (after 6 months) was a stupid waste. Usually I can catch the low and treat it (with some juice 15 - 30 grams carb) as I described in the previous post. There is another emergency treatment nasal spray product called Baqsimi. They come 2 to a package and have a longer shelf life than Glucogon. I tried that once. It was a really nasty experience (burns in your nose and feels like you are drowning) and I immediately spiked into the 300’s. I think I will stick with the juice or honey treatment.
Thank you for mentioning the Unisom Adhesive Remover. That is what I was thinking of but couldn’t remember the name.
You sound like you are more savvy when it comes to technology than I am. My husband gave me an Apple Watch. I didn’t want it. We gave it to our daughter. My husband has all things Apple. He has an app called Follow on his Apple Watch to share my blood sugar readings from the Dexcom G6 and gets alarms of my highs or lows. If I upgrade to G7 I hope that is available. When I started using the Omnipod 5 pump it wasn’t compatible with iPhone. So I had to have a separate controller. I think that is a change to look forward to soon. I heard from Dexcom and Omnipod that there are developments in the works. Ideally I hope to upgrade to Dexcom G7, have it work with Omnipod 5 ( to communicate blood sugar levels) for basal and bolus insulin delivery recommendations, and have both of them “playing nicely” with my iPhone. As you said, it is a lot to consider.