From my 2022 archive:
Other than one steroid injection for my shoulder issues (a whole separate story), I had never taken steroids prior to my cancer diagnosis. Unfortunately, many chemotherapy regimens require oral steroids for either a few days surrounding each infusion or every day in certain situations. In my experience, the steroids quickly wreaked havoc on my blood sugars.
My chemotherapy regimen (TCHP every 3 weeks for 6 cycles) required me to take 8 mg of dexamethasone twice a day one day before and after chemo (day -1 and +1) and then 4 mg in the morning of day +2. On the actual day of my infusion, I received either intravenous (IV) or oral dexamethasone from the nurse during my treatment. I checked in with my endocrinologist before starting chemo, and she told me to start out taking about twice as much insulin when bolusing for food.
Turns out I needed more than that to keep my sugars under control. I would take 2.5 to 3 times the amount of insulin to bolus for carbohydrates. Of course, as with all things diabetes related, I started slow and increased as I learned the effects of the steroids on me. I also tried to eat low carb on those 4 days, which helped me have better control without having to take massive doses of insulin.
- I’m lucky to have great health insurance that allows me to have a closed loop insulin pump and continuous glucose monitor (CGM)
- I have an endocrinologist that trusts me to use my own judgement and understands that I know my body more than she ever will <3
- Despite their challenges from the blood sugar perspective, the steroids give you a boost, and you don’t start to feel crappy from your infusions until the afternoon of day +2, when the steroids start to wear off
- For people who continue to work during chemo, this can help you get through your workdays by timing the treatment so that the worst days occur when you are off from work
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