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May 9, 2008

Daily Care, Other Medications

Question from Tampa, Florida, USA:

My seven-year-old son, who is on a pump, is just starting on Pulmicort Respules 0.25 twice daily with the nebulizer until his cough is gone, then another week on the same schedule. This was prescribed by our pediatrician. We discussed how this would raise blood sugars and I said I would contact our endocrinologist on how to regulate the blood sugars effectively. She stated to watch and make correction boluses. I would really like to have more “concrete” information on how to be proactive rather than react for the next few weeks. What do you suggest?


From: DTeam Staff

Hopefully, with inhaled steroids, you should not see much effect on glucose. That’s the idea of inhaled. Just to give you some math: 250 mcg every day for a year is less steroids than he would take by mouth for three or four days. Your pediatrician is correct in using inhaled steroids to try to prevent the need for oral steroids in much larger doses guaranteed to raise glucose more significantly. I think your endocrinologist is correct. You may have mild adjustments to make, but a “proactive” increase in basal, etc., might just find you fighting hypoglycemia.