[Gruncle]

Diabetics and reactions to dexamethasone

by Gruncle on Fri Apr 25, 2014 1:57 pm

HI,

I finally stared my CyBorD [Velcade, Cytoxan, dexamethasone] therapy last Friday. Must say I didn't experience any drastic side effects other than the fact my blood glucose levels shot up to 400.

Yikes (normal target levels are 80 to 130). 400 is borderline "diabetic coma" level, a scary place to be.

My oncologist had forewarned me to expect a "bit of a spike", but said nothing of numbers bringing me to the edge of the coma cliff! Thanks dexamethasone.

I would appreciate hearing from others in the Beacon community who are dealing with Type 2 diabetes, dex, and related effects.

Stay positive and strong!

Doug

[Airedaleowner]

Re: Diabetics and reactions to dexamethasone

by Airedaleowner on Sat Apr 26, 2014 1:47 pm

I am on dexa­metha­sone every other week for 4 days. On those days, my glucose goes up and I do sliding scale insulin . I check my blood sugar 4 times per day on those days and give myself an insulin shot if blood sugar is above 125. On the days I'm off the steroid, I have no elevation of glucose.

[big bill]

Re: Diabetics and reactions to dexamethasone

by big bill on Sat Apr 26, 2014 9:16 pm

I have been on dex now once a week 40mg and on the day I take it and up to total of 36 hours my blood sugars do go up, but not that high. My normal is about 135 to 147 and it raises it to 245.

The problem I have with dex is that I myself am wired for up to 24 hours. No sleep, then a couple of jet lag days afterwards.

[Gruncle]

Re: Diabetics and reactions to dexamethasone

by Gruncle on Sun Apr 27, 2014 1:56 pm

Hi bigbill,

I am on the same dose/schedule as you and I too am wired for about 36 hrs with a "nasty" crash.

After speaking with my PCP with regards to this outrageous glucose spike, we decided on a preemptive strike by increasing my dose of Lantus (long acting insulin used once daily, usually at bedtime) and to injecting it as soon as I wake up and waiting a couple of hours before taking the dex.

And, of course, I will continue to take metformin & glyburide. Going to meet with an endocrinologist to design a long term glucose control plan for the duration of my chemo.

Thanks for the input.

Doug

[pamcakesky]

Re: Diabetics and reactions to dexamethasone

by pamcakesky on Tue Apr 29, 2014 5:00 pm

My husband also has diabetes, and so far his reaction to the Decadron [dexamethasone] as part of his myeloma treatment has been manageable. He takes no medication for the diabetes, and the doctors monitor his A1c every 4-5 months.

The highest his glucose has been with the dex is 158. Yesterday is was 91. It changes weekly. The oncologist won't get worried until it goes over 200. A recent A1c test came in at 5.9, which was great.

However, his bilirubin levels have been the challenge for us. He is now down to one treatment per week, which his body should tolerate better.

[Rvwoodin]

Re: Diabetics and reactions to dexamethasone

by Rvwoodin on Wed Apr 30, 2014 6:09 pm

I have have type 2 diabetes since 1995 and was treated only by pills. I was upgraded to multiple myeloma December 19, 2013 (from nine months of smoldering myeloma) and started on Revlimid with dexamethasone in January 2014.

My blood glucose shot up immediately to almost 400. -- The sliding scale insulin asparte did not work to control the blood sugar. I was put on the Novolog 70/30 mix in a pen at 20 twice a day and had the dex stopped.

I am now under control again, between 80-120 for blood glucose.