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[IP] Re: Cortisone Shots

On Monday, December 13, 2004,Sharon wrote:

>  I received a cortisone shot last week am dealing with
> high sugars.<snip> I don't want to over correct
> the temporary basal but I was wondering how long the cortisone stays 
> in the
> body.
Kathleen responded:
> I think it depends entirely on the dosage.
> I was able to up my temporary basal about 2 hour before the shot by
> 20% and leave it that way for about 4 hours for one day and was fine.
 From previous discussions on this topic, I'd say it was a real YMMV 
situation.  Back in the 80s and early 90s, I had many, many cortisone 
injections, most for trigger fingers, but also for frozen shoulders, 
heel spurs, and De Quervain's tenosynovitis.  I believe I did not have 
much of a reaction to the first finger  shot, but this started before 
MDI, much less pumping.  But after that, I noticed  high bgs after each 
shot, and pretty quickly, I was able to predict a bg rise on the second 
day, that lasted (for me, at that time) for about 2 weeks, and learned 
to increase my insulin dose by about 40% total (proportionately more in 
daytime, for safety).  I remember noticing that the time I was given a 
relatively large injection in my shoulder, and 2 days later 2 in 
fingers, that the bg response seemed about the same as when I got just 
1 finger injected, so I don't think the dosage per se was making much 
difference for me (but I guess it's possible that the finger injection 
had the amount necessary to cause the full reaction, and Kathleen's 
heel injection didn't -- my heel injection had been before MDI, in the 
early days of hbgm, and, while I know I had problems with highs, I 
wasn't able to quantify them).

However, a few years ago, when I got cortisone injected in 3 fingers, 
my insulin need went sky high for a few days, requiring a lot of 
corrections even with a tripled basal dose.  I then had to keep my TDD 
at a little over triple my usual for over 2 months, and even then came 
back to normal slowly.  So it's not just a Your Mileage May Vary from 
mine, it's a My Mileage May Vary from mine <gr.>.  Anyway, because of 
that experience, I am having my wrist operated on next Monday for De 
Quervain's, after many months of trying everything else EXCEPT another 
cortisone shot.

Linda Z
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