Remember that the information presented here is not intended to replace the care of your own doctor. Before making any changes in the management of your own illness, you should consult your physician or other qualified medical professionals.
Question
My mom is on prednisone for 15 days with a decrease in dose every 5 days. Her sugar levels are scary — in the in the 500 mg/dl [27.8 mm/l] and 600 mg/dl [33.3 mm/l] range! She takes Regular insulin to bring it down, but it doesn't bring it down enough. What should she do? Stop the prednisone?Answer
Yes, the prednisone is probably responsible for the high blood sugars. But you and I will have to assume that the doctor had a good reason for using prednisone (a steroid medication) in someone with diabetes.She definitely should not stop the prednisone without discussion with her doctor. You don't describe how much prednisone she's getting in each daily dose, and that's a factor in deciding whether to stop, as is the underlying disorder that is being treated -- abruptly stopping prednisone will mean whatever disorder was being treated may flare up.
My first concern for anyone with severe hyperglycemia is adequate hydration. She should be encouraged to drink lots of water, and if she develops any nausea or is otherwise unable to drink enough fluids, she should be immediately evaluated and treated with intravenous fluids in an Emergency Room.
The next thing for you to do is arrange for her to call her doctor and let him/her know that the present program (using Regular insulin to bring down the blood sugar) isn't working. The doctor may advise other diabetes medications (such as more rapidly acting insulin analogs like Humalog or Novolog), or increasing her dose of whatever other diabetes medications she might be on.
There's also a chance the doctor might decide that stopping the prednisone is a good idea, but that's a medical decision based on factors that you haven't described in your e-mail.
PS: Also see your doctor advises using steroids.
