April 30, 2013
Hyperglycemia and DKA, Other
Question from Lizella, Georgia, USA:
My 15-year-old daughter has type 1 diabetes and PCOS. She is on an insulin pump and she also takes 1500 mg of Metformin ER daily for insulin resistance caused from the PCOS. She was on the Ortho Evra patch for the PCOS but, this week, she switched to the Depo-Provera shot. Within hours of taking the shot, her blood sugar became high and has stayed that way. We can’t get her below 300 mg/dl [16.7 mmol/L]. They changed her pump basal rates and her insulin to carbohydrate ratio as well as her sensitivity factor. We are correcting her blood sugar every two hours through an injection and her blood sugar remains between 300 and 600 mg/dl [16.7 and 33.3 mmol/L]. Did the shot cause her blood sugar to increase? How long will this last?
Answer:
Yes, it is likely the progesterone with which she was injected has caused her to be even more insulin resistant. The Provera is a long-acting form and will last weeks. I anticipate that your daughter’s basal rates and bolus doses will have to be increased to address this. It will be up to her doctor and the patient (with help from mom and dad) as to whether she wants to continue the progesterone or try something else. This is a known side effect of all types of progesterones. They are known to cause insulin resistance.
JTL
