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, the mixed insulin NovoMix® is used.
A suitable starting dose, depending on blood glucose values, is 10 units at lunch or, if needed, both at breakfast and lunch. The dose or doses are usually increased by 10–20% every 2–3 days if blood glucose levels are above target. If blood glucose is high before dinner, increase the lunch dose; if high before lunch, increase the breakfast dose.
Reducing the NovoMix® 30 insulin dose when the corticosteroid dose is lowered is assessed individually. A commonly effective reduction: 50% decrease in corticosteroid dose → 25–30% decrease in NovoMix® 30 insulin dose. Support from a diabetes nurse or doctor is recommended when adjusting doses.