Steroid-induced diabetes while on treatment for esophageal cancer

My elderly mother's blood sugars spiked in the mid-250's on prednisone. My young daughter, way back, spiked in the 400's on prednisone and it turned out that she actually had type 1 diabetes.

Since she has had type 1 for many years now, we can say reliably that steroids may triple blood sugars (though 6-8mg is a lowish dose). Any chance he can go down, or any chance there is another med to help him?

Blood sugars in the 400-500 range are dangerous, again, in our experience. Look up diabetic ketoacidosis. If the values don't come down I would seek emergency care. Do you have ketone sticks? Pharmacies sell them. If ketones are high it can be quite urgent.

Have you called the doctor?

Thank you for your reply. We are seeing the Dr again today. We will get a testing kit. I will also ask about ketone strips. I have asked if my husband could now try weaning off of the 6 mg of dexamethasone. We will discuss that today. We have outstanding medical care, locally and at Mayo. However, I do believe one can learn a lot from actual patient experiences, all the while realizing each person is different. This new blood sugar component is very new to us!

Curious how you know blood sugars without a meter! Definitely get a meter, strips, lancets and swabs.

When we saw the PA on Tuesday they did blood work. Yesterday we met with a patient coach who set us up with all of the necessary equipment for testing blood sugars. It was explained that since my husband is experiencing the high blood sugars due to the steroids it is not the same as type 1 or type 2 diabetes. His glipizide was increased to 10 mg with breakfast. He will decrease his steroid to 5 mg a day.

It is "drug induced diabetes." What did the PA say about those very high blood sugars. Did they recommend ketone strips?

They do not seem overly concerned about the levels. No ketone strips were recommended.

When my mother-in-law had this during radiation treatment that included steroids to reduce swelling, it resolved as treatment ended and steroids were tapered. Her oncologist had failed to have her monitored daily as the radiation protocol recommended, and we had no clue until she had a seizure. Now we know the protocol for treating steroid induced diabetes is generally monitoring plus treatment with medication or insulin, depending on patient response.

If your husband's blood sugar levels stay above 250-300 even after increased glipizide & reduced steroids, he is possibly at risk for ketoacidosis Since the meter doesn't check for this, ketone testing might be needed. So, if the levels stay up, you might want to ask the doctor...

I understand the difficulty you face with offering food and drink - but additional water is highly recommended to reduce both ketones & effects of the diabetes and radiation.

Is he willing and able to drink more water?
Sue

I’ve had diabetes for 45+ years. I was prescribed prednisone for treatment of pneumonia once. During that time my blood sugars spiked to over 500. I was already on insulin and had to take some corrective doses to treat the high blood sugar readings. I also tested for ketones and increased fluid intake (water). The extreme high blood sugars resolved when the pneumonia did and I was off the prednisone. Since then I’ve asked my providers to avoid steroids if I need treatment for something.

Thanks to all of you for your replies.
My husband is drinking lots of water and with the increased glipizide his blood sugar was 237 this morning. We are very thankful!!