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Asthma medication and impact on blood sugar

Discussion in 'Parents of Children with Type 1' started by shannong, Sep 5, 2013.

  1. shannong

    shannong Approved members

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    My son was diagnosed with asthma last year (same time as diabetes). He was able to go off his asthma medication during the spring and summer months which is apparently quite common. The doctor wanted him to re-start his inhaler as soon as school started due to the potential of cold/flu season starting which can make asthma worse. So, I gave him his inhaler at 4 pm last night. Then I had a strange night of blood sugar numbers. At 8pm his bg was 130 and then at 9pm his bg was 324. In one hour he rose almost 200 points and that was without any food (his last meal was at 5:30pm!). Now, my son often does rise at bedtime, but I had a 200% temp basal going, which I always do. I couldn't get his bg down until 2am, all the while correcting and keeping a temp basal going.

    Is this some kind of response to the asthma medication? My doctor thinks it is absolutely necessary to start him on the asthma medication in order to prevent any problems. She says that it takes 2 weeks for the medication to totally kick in, so I should not wait. But, I kind of don't like having him on medication if he is currently not having any asthma symptoms. I worry about how it will affect his blood sugars (especially after day 1). I know uncontrolled asthma is worse, but it is hard giving him medication when he is currently symptom free.
     
  2. AliciaM

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    Some inhalers have steroids in them and steroids usually raises bg. What inhalers does your son use? I take advair on occasion and will have to start taking it again, regularly, soon as it starts to get colder out and flu/cold season starts. I haven't taken my advair in months so I don't know how it will effect my bg yet. If I'm having a lil trouble I take my ventolin everyday for a few days and I'm ok. Ventolin (salbutamol/albuterol) does not contain any steroids.

    Advair, flovent and symbicort which are used often all have steroids in them. Maybe you could ask your sons GP to change the dosage?
     
    Last edited: Sep 5, 2013
  3. shannong

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    He is on Alvesco, an inhaled steriod.
     
  4. MyHandsAreFulll

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    My daughter uses a nebulizer occasionally and it wreaks havoc on her bg. It seems to make her resistant to the insulin. The best way we have found is to use the meds when there is little to no insulin on board (2-3 hours after eating), and to give a bolus before treatment to cover the rise from the meds. Good luck finding what works for your son!
     
  5. AliciaM

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    Ask your sons GP if you can try advair or symbicort instead. It has an inhaled steroid and a bronchodilator in it. I find they work better so maybe this is an option. Also regardless if you switch long acting inhalers or stay with the alvesco maybe he can lower the dosage. If his asthma is well controlled then I don't see why he needs to take the full dose of what he was taking when he was diagnosed.

    I agree with you. I know I'm "supposed" to to take my advair all the time and I always get the "speech" about how I'm not using it to its full potential blah blah but I don't feel I need to take it if my asthma isn't bothering me.

    I would just talk to your GP and say look I get that we want to decrease his risk for asthma related problems during the cold/flu season but we also need to think about his diabetes and how it effects his bg and find a solution. There are a few diff inhaled steroids he could try and lowering the dose should also help.

    I know it's not an answer but hope this helps a bit.
     
  6. MEVsmom

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    We are newly diagnosed, so I am by no means an expert, but we asked the question, "are there any medications we need to avoid?" The answer was steroids. The CDE said, yes, take them if you absolutely need to to, but call us and let us know and realize that they are going to mess with your blood sugar (not those exact words).
     
  7. shannong

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    Thanks for your responses. I am convinced it was the inhaler that day that sent his bg soaring, because I did not give it the next day and his bg's were much more predictable.

    I've decided that I am not going to give him the inhaler, until I see a real reason to start it. I agree with you Alicia, I am dealing with not only asthma but also diabetes, so I think there has to be an approach based on that.

    Alicia, when do you usually start your inhaler?

    Thanks!
     
  8. Megnyc

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    I see slightly elevated blood sugars with flovent which I believe is similar to what your son is on. I used to take it twice a day during the fall/winter and just increased my basal for those months.

    I'm actually a big fan of using preventative asthma meds because dealing with oral prednisone (which is sometimes necessary if things get bad) is infinitely more difficult than the simple basal increase most inhaled corticosteroids require. Personally, I would recommend consulting with a pediatric pulmonologist before making the decision to discontinue the medication.

    I would also ask for a prescription for a spacer if you don't already have one. This will insure as much of the medication as possible makes it to the lungs. http://www.asthma.ca/adults/treatment/spacers.php
     
  9. AliciaM

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    I usually start taking mine by mid-end of october. The cold really bothers my asthma and since it gets below 0 here and up to minus 40 in the winter I can't really avoid taking it by dec/jan. I also get bronchitis at least once a year so I usually have to be really strict with taking my inhalers so that it doesn't get worse and turn into pneumonia.

    Definitely ask your GP about dialing down the dose or switching to something that has less steroids in it.
     

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