High Blood sugars with CFRD

[shamrock]

Ok, so I've had this CFRD thing for about 6weeks now. And for maybe the last two weeks my sugars were very good. Then on Thurs I began to feel like I should be taking more creon (if you catch my drift) and my sugars have been slowly getting higher and higher. Over here we measure them differently to the states, but I'll say what they are anyway in the hope someone reading understands them.
So normal ranges are between 4-7, for the most part under 9 anyway. This evening they were 15. This isn't exceptionally high, but still 'test for keytones' range. I'm quite dissapointed because I really felt I was making progress in managing them. I check them 4times daily, and my dietary routine is fairly routine (like I eat same size meals and mostly the same food everyday).

So can anyone think of what might be going on here? Could my 'loose' motions be connected? I'd be grateful for any input or advice. Im very confused and not very happy! Thanks everybody!

 

[EnergyGal]

ok here is my opinion. You had a transplant right? If so, then if you increase your enzymes or perhaps change your enzymes (brand) then you might be digesting your food better as well as absorbing your anti-rejection medications. If that is so, then it is possible that the drugs are causing your elevation of blood sugars. Prograf, prednisone and a whole bunch of other drugs can cause diabetes.

I say watch your carb intake and increase your activity and find a better level for yourself. If you increase your enzymes always have a anti rejection level checked because that will potentially increase your levels of your drugs. You can also be more prone to infection if your drug levels increase.

IF you need to be on all these enzymes, I suggest you deciding on what the amount is going to be and stay at the dose. You will be hopefully become stable.

Do you take your drugs with food? Whatever you do always take your meds the same way each day. If you like to take them with food that is fine but try not to mix your food one day and then take your meds on an empty stomach. That too will affect your serum level of your drugs.

Best wishes

 

[anonymous]

Thanks Risa. Well i think i NEED to increase my enzymes...I've been absorbing really terribly since Thurs. It worries me a bit because Im thinking if Im not absorbing my food, then I mightned be absorbing my antirejects. I can't think of anything I've been doing differently from wed to thurs to now, thats why this is such a mystery.

Also Risa, if you take anti rejections every 12 hours (twice a day) what is the most time you can be comfortably out with taking them. By what I mean is, you obviously can't be SIX hours late taking your night time drugs, but can you be 20mins late? Or what is acceptable...Thanks

 

[EnergyGal]

<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>anonymous</b></i>

Thanks Risa. Well i think i NEED to increase my enzymes...I've been absorbing really terribly since Thurs. It worries me a bit because Im thinking if Im not absorbing my food, then I mightned be absorbing my antirejects. I can't think of anything I've been doing differently from wed to thurs to now, thats why this is such a mystery.


Also Risa, if you take anti rejections every 12 hours (twice a day) what is the most time you can be comfortably out with taking them. By what I mean is, you obviously can't be SIX hours late taking your night time drugs, but can you be 20mins late? Or what is acceptable...Thanks</end quote></div>

If you increase your enzymes have your blood serum level for your antirejection checked as I stated above. Enzyme increase digestion and drug levels. This all can increase your Blood sugars (IMO)

hopefully you can stick to the same time. If you are up to one hour late I guess that is fine. Better late than never but if you miss an entire dose an miss six hours, you might want to check with your nurse because that will be cutting into your next time.

 

[Kimmiek]

Hi Shamrock,
My brother's CF clinic has a CFRD specialist. We spent 4 hours with her one day and she explained how different it is and how it needs to be managed differently. I hope this helps you;
She explained you need to act as the pancrease would ahead of time. We tested Mike's sugars before eating, then 2 hours after. Mike's baseline (in the states) was 110. So prior to eating if it was high he would give a corrective dose plus count the amount of carbs (unlimited) so if he ate 100 carbs he would have 10 units of insulin prior to eating. Normally, at the 2 hours after, he would have stayed at 110. Now that ratio (amount of insulin to carbs) would decrease (instead of 1 to 10 it would go to 1 to 6 or something) if he was on large amounts of prednizone or some other medication that would mess with his sugar. He could give insulin up to 3 times a day (plus he was on lantis for long acting 1 per day). Three meals a day, then any snacks in between were usually less than 5 carbs. We bought some low carb protien shakes which were AWESOME for in between....Try "whey gourmet" cookies and cream...You can actually mix it with water and it still tastes just like cookies and cream ice cream! I made ice cream and pudding with it for him too (ok, and for me : ) )! mmmmm...
I would talk with an endocrinologist who is familiar with CFRD, maybe make some calls. You don't want high sugars for a long period of time. The Endo explained that it increases the amount of infections and exasperations you will have if it is not managed correctly since bacteria feeds on the sugar in your blood. After we saw her, Mike went the longest he had in a while without an exasperation.
Good Luck!! And if you have any questions, please feel free PM me : )

 

[kybert]

im assuming you take insulin. do you take a long acting one as well as the fast acting? if not, try adding a long acting one in. this can make a BIG difference.

oh and lastly, dont get too upset at being at 15 for a while. it wont kill you to be at that for a few days until things get sorted.

 

[anonymous]

Thank you Kybert and Kimmiek for your responses. At the moment I test my b/s 4times a day and take insulin 4times a day as well. Im on Glargine (lantis i think?) at night to carry me 24hours. I take Novorapid with my meals which is three times a day. Well as I said, last night I was 15.1, I took my Glargine and this morning I was 5.7. While 5.7 is perfect, I was told that having that drop from 15 to 5 over night isnt a good thing. I reckon I'll give my diabetes nurse a ring on Mon. All your responses have been very helpful though. I'm going to check my b/s in a while so Im hoping its normal.

(Oh and also OTHER things I mentioned before are good so far today, so touch wood that will continue..)

Shamrock, x

 

[Kimmiek]

Good to hear it! Yes, give her a call but I would also try to find an endocrinologist who specializes in CFRD if you can.
Best of Luck to you!

 

[kybert]

does it get high right after meals or does it just creep up slowly as the day goes on?

 

[anonymous]

sugar?