Patient's Query
Hello doctor,
I have been living with Type 2 diabetes and had been managing it reasonably well until I was diagnosed with lung cancer six weeks ago and began chemotherapy. Since starting treatment, my blood glucose levels have become highly unpredictable, fluctuating from very high to very low within the same day. I have also observed that the steroids I get administered with the treatment seem to be contributing to these oscillations.
I am testing my blood glucose multiple times per day and changing my insulin as instructed, but sustaining levels has become harder and harder. Suggestions regarding how chemotherapy and steroids can affect diabetes, along with any suggestions for helping to control both conditions during the process of cancer treatment, would be greatly appreciated.
Thank you for your time and advice.
Would really appreciate any recommendations you have.
Hello,
Welcome to icliniq.com.
I understand that you are concerned about your blood sugar going up and down.
This is a common feeling for many people receiving chemotherapy, especially when steroid drugs are involved, and it might be nice to know that you are not alone. Steroids can raise blood sugars dramatically. Other factors, such as changes in appetite, sickness, decreased food intake, stress, and the effects of chemotherapy itself, can contribute to both high and low blood sugar readings. These changes can occur in persons without diabetes; they are not unusual when cancer therapy is ongoing.
It is good that you are checking your blood glucose at home consistently. Monitoring frequently is one of the best methods to detect changes early and adapt treatment as your healthcare provider advises. During this time, your blood sugar levels may feel all over the place, but keeping a close eye on them can help lower the chance of developing issues and allow for early treatment.
Blood glucose levels are often more easily controlled when chemotherapy is complete, and steroid treatment has been lowered or discontinued. Depending on the overall treatment strategy and the individual response, you may find that your diabetes control will gradually return to the pattern you had before.
Eating well, staying well-hydrated, and eating regular meals whenever possible will also help to encourage better blood sugar control during this time. If you are consistently seeing high or low blood glucose readings while following your treatment plan, it is crucial to talk to your oncology and diabetes care teams, as temporary modifications to your diabetes medications or insulin doses may be needed during chemotherapy.
Management, which has to be provided, should include the following:
Proceed with your current management program and try to receive the best possible supportive care.
Maintain routine monitoring of your blood glucose levels and adhere to the guidelines of your oncology and diabetic care providers in regard to drug adjustments.
Revisit us in seven days or before in case of persistent extreme changes in your blood glucose levels.
Wishing you a speedy recovery.
If you have other questions or need clarification on anything else, don’t hesitate to ask.
Thank you.
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