In the case of short cortisone therapy lasting 1–2 weeks, blood sugar levels that are temporarily above the target range may be satisfactory. Need for increase in blood sugar medication is recommended to be discussed at the start of the cortisone therapy. If cortisone therapy lasts for a longer period of time, it is often necessary to start temporary insulin therapy.
If your blood sugar is higher than 10 mmol/l after dinner, you should also check your blood sugar before lunch, roughly 2 hours after lunch and before dinner. If these checks show that your blood sugar is higher than 7–8 mmol/l before a meal and higher than 10 mmol/l after the meal, the diabetes therapy should be intensified, depending on the duration of the cortisone therapy.
Temporary insulin therapy
In temporary insulin therapy, intermediate-acting NPH insulin is used as a morning injection, which aligns the peak effects of the insulin with the morning dose of cortisone most effectively.
A suitable starting dose for most individuals is 10 units in the morning. The insulin dose is adjusted according to blood sugar levels and the cortisone dose every 2–3 days.