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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Can Cortisone Be Substituted With A Better Steroid To Control The Sugar Levels?

I have type 2 diabetes and have been on medication (glyburide and now Mediformin) or 12 years; I am now 82. I need to take cortisone about every three-four months, but following a shot, my glucose readings spike. This morning it was 265 after yesterday s shot; the usual readings are in the 130s for the last several months. Previously the morning readings were in the 120s. Otherwise, I am in excellent health, eat well, and walk about two hours every day. Question: is there a better sterioid than cortisone for diabetes patients? thank you, Nancy Cella
Tue, 13 Dec 2016
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General & Family Physician 's  Response
Hello Dear. All corticosteroids like cortisone or prednisolone causes the same level of raise of blood sugar. There is nothing like a better substitute for cortisone. Some of the tips i would like to suggest you are

1. Plan to take your blood sugar more frequently while taking steroids (3-6x/day)
2. Be especially careful with maintaining your eating plan designed for your diabetes. If you eat
a lot of carbohydrates or larger portions your sugar will rise faster.
3. If on oral pills to treat your diabetes know what pill to increase if blood sugars get above a
certain level.
4. If on insulin be sure to have a sliding scale of how to dose your insulin if your blood sugar gets
above a certain level.
5. If on an insulin pump frequent correction boluses may need to be done.
6 . The healthcare provider may need to call the person that manages your diabetes for exact
information if at a urgent care or emergency room.
7. If recommended to take steroids for a extended time (more then 5-10 days) make an
appointment with your diabetes provider to develop a long term plan.

Hope i have answered your question. Feel free to contact me if you have any more questions. I ll be glad to help you.
All the best
With warm regards
Dr Sanjay Kini
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Can Cortisone Be Substituted With A Better Steroid To Control The Sugar Levels?

Hello Dear. All corticosteroids like cortisone or prednisolone causes the same level of raise of blood sugar. There is nothing like a better substitute for cortisone. Some of the tips i would like to suggest you are 1. Plan to take your blood sugar more frequently while taking steroids (3-6x/day) 2. Be especially careful with maintaining your eating plan designed for your diabetes. If you eat a lot of carbohydrates or larger portions your sugar will rise faster. 3. If on oral pills to treat your diabetes know what pill to increase if blood sugars get above a certain level. 4. If on insulin be sure to have a sliding scale of how to dose your insulin if your blood sugar gets above a certain level. 5. If on an insulin pump frequent correction boluses may need to be done. 6 . The healthcare provider may need to call the person that manages your diabetes for exact information if at a urgent care or emergency room. 7. If recommended to take steroids for a extended time (more then 5-10 days) make an appointment with your diabetes provider to develop a long term plan. Hope i have answered your question. Feel free to contact me if you have any more questions. I ll be glad to help you. All the best With warm regards Dr Sanjay Kini