Eczema treatment and the effects on two diabetics and one non-diabetic hypoglycemic

So, some context first.
My partner, D, is a type 2 diabetic, Cadmium is as well. Cadmium needs insulin, D has his managed through non-insulin medications. I have non-diabetic hypoglycemia, and have been diagnosed with it since I was a toddler. I'm being sent to an endocrinologist soon to try and figure out what the root cause of my condition is, so I can better manage it. D and I use CGM systems, specifically the 14 day FreeStyle Libre. D recently started having hypoglycemic episodes for the first time, and I was able to help him through it whenever it popped up until we could get him into the doctor. What's really interesting?

I haven't had a hypoglycemic episode since D's birthday, Nov. 19th. Neither has D. Cadmium's glucose has started being insanely hard to control since the night of the 20th, when he had numbers in the 300s and would only have brief breaks into better numbers. His numbers would also frequently go into the reds and blacks. Something changed that affected all of us- and I think I finally figured it out, as I started having an eczema flare at around that time....

And to treat those flares.... I was prescribed a triamcinolone acetonide 0.1% ointment. Which I somehow forgot, was a steroid. Specifically, a medium-to-strong strength corticosteroid. And can raise blood sugar pretty easily if you are sensitive to it.



Sometimes it really is the little things that get you! I realized Cadmium was sensitive to topical steroids when he started needing Gentizol for a flare up of his yeasty ear infections. You can see it in his AM cycle for yesterday (12/08) as his values suddenly went up after he had some applied to his ears! He has since discontinued that, and I am now focusing on cleaning his ears more frequently.

So I am going to make sure I keep use of my eczema ointment as FAR away from him as physically possible. No touching him or his things with it on! And thorough washing it off before I interact with either! Figured this out thanks to a troubleshooting page courtesy of AAHA.

Of course, my hypothesis will need to be tested out to confirm this, but it has been a hell of a time trying to figure out what it might be that suddenly caused his insulin to lose its (admittedly rather extreme) effectiveness!! As for the few numbers before the 19th that are high, I bet I might have used a small amount of that ointment the night before, as I usually would apply it around bedtime. Coincidentally, my bedtime used to be around his PM shot.... Hmm....

I cannot confirm for sure for those few numbers before the 19th, but I do know for sure when he started having streaks of high numbers starting around the 20th I was using it.

Ughhh!!! Lol.

 

Very interesting.
I’m glad you figured it out.

 

Am answering you on the main page…looks like the BGs is slowing down but I would get another test in 1 hour is you can.

 

I will attempt to, I'm making sure he finishes the rest of his half can snack that was given at +3. It is almost 4am for me so I'm hoping I won't doze off. Have alarm for +6 but have been sleeping through my alarms pretty bad lately, even at full volume! Thanks to my roommate waking me up it hasn't caused his insulin doses to be late but almost did.

 

Must be hard having a roommate and having to stay up late testing. Must be a good roommate!

 

I live with my partner D and roommate C, and it really helps that we have different sleep cycles due to differing health conditions and obligations! C is able to wake me up in the mornings because he works 5am-9am at a hardware store. Partner also works but usually in the afternoons/evenings. Partner can occasionally get BG tests, but doesn't have as much experience as I do. Unfortunately only I have administered insulin, but D was there during the training- hes just worried about getting a fur shot, aiming wrong and hurting Cadmium, or accidentally breaking the very expensive vial. Hypersomnia means I am always always tired, and usually need 10hrs of sleep to feel rested- but can often take naps if my meds and anxiety allow me. Haven't really gotten that much sleep since Cadmium's diagnosis, but I'm hoping I won't need to stay up for lengths at a time quite so late forever! It also helps that there's a spare bedroom in this 3 bedroom apartment that Cadmium can stay in, so I can keep his litterbox and food separate from the non-sugar cats. It's all very complicated, lol

 

Yes I can see it is a bit complicated but looks like you are working things out well. Lucky Cadmium!

 

Haha! He is lucky and a spoiled little prince! Due to me being disabled from psychogenic non-epileptic seizures (theyre bad enough that I need to use a wheelchair for if I leave the house) I get to stay at home with the cats allllll day. Assuming I don't have a doctors appointment, that is. Which they love because they all have separation anxiety
8 more minutes to go

 

He's at 220 and cranky that I woke him up, so I think now is a good time for us both to get some sleep!

 

I agree. Sleep well!

 

@FrostD @Suzanne & Darcy
Wanting to make sure you both are kept in the loop, I figured out a key component as to why Cadmium's glucose levels have been ridiculously hard to control lately.

 

Interesting theory, let's see what happens!

While not the same, my fasting BG (even just a few hours) is always far too low. It also causes blood pressure to drop pretty low... I always have to keep snacks by the bed or getting upright just doesn't work.

 

Yup! That could be due to something called fasting hypoglycemia, and depending on how soon it happens + labs it could be classified as reactionary, hormonal deficiency based, or idiopathic. My fasting BG will start to drop at around 3 hours, even when I have eaten a meal absolutely chock full of carbs. This means I tend to either 1) constantly snack on something 2) have to eat smallish meals every 3 hours or 3) have horrible nightmares when I start going too low in my sleep. My mom has this too, and our A1Cs are completely normal so its not due to pre-diabetes. Pre-diabetes can cause hypoglycemia due to the pancreas having no idea what the correct amount of insulin is. At first it'll overproduce it, then later burns itself out and turns into diabetes. We think there might be some hormonal deficiency at play here for me, specifically GH, but don't know for sure just yet. At one point I was sitting at around 60 for a half hour, and my doctor tried to insist it wasn't a hypo event because once I realized thats why I was feeling awful, I ate some food to counter it! Why would I let it go even lower once I figured it out??

But yeah, I am very, very familiar with the bed snacks approach lol. Currently I have Doritos and Gardettos, as well as some soda!

Since making sure Cadmium isn't being exposed to any steroids, his curves are acting like, well, an actual curve. I couldn't figure out what was happening when it started looking like a rollercoaster- if it was a rebound from insulin overdose, if it was too little insulin and not lasting the whole cycle, reading ingredients lists of everything he eats..... It was a nightmare. But hey!! Last night he was mostly in yellows and blues! So I might be onto something, but will need to see how it goes. AAHA suggests discontinuing steroids and reevaluating with a glucose curve 2 weeks later.

 

Great job of detective work! I read an article on the use of NSAID creams that cautioned to not let your cat lick the cream off of your skin. NSAIDS can cause renal damage in cats.

 

Doesn't surprise me! NSAIDs are extremely bad for their little kidneys. And can be for ours too if we take too much!

I also heard that the effects of essential oils in diffusers/aromatherapy or to moisturize hands is heavily discouraged, same with using CBD balms that have any THC in it, even trace amounts. Lots of things are bad in many forms- if it is aerosolized, in contact with thin skinned vascular areas, in contact with blood/broken skin, or is able be licked off? Best to avoid it.

I think what happened for Cadmium was after I applied my steroid ointment, if I checked his glucose, that meant I was touching his ears. He demonstrated that he is sensitive to a much weaker steroid with his ear ointment, so not surprising that triamcinolone acetonide affected him. Hopefully his body can calm down and come back down from the 400s at the end points of his curves (and preferably be under 200 for the length of his cycle) without more of a boost with insulin. I think I just need to give him some time at this dose, which I am going to do anyways per SLGS.

I also heard that glucose tends to be higher when asleep, as the body is using more energy to heal? Do you know if that is accurate? Because that might also contribute to why his AM cycle tends to be higher, he has been sleeping primarily during that cycle ever since his diet/feeding schedule changed.

 

What you're likely describing is called "dawn phenomenon." It's part of the body's natural rhythm. It's the way the body prepares for the stress of the day. Corticosteriods (aka "stress hormones") are released to help deal with those upcoming stresses of the day. As a result, AM blood glucose levels may be higher.