I thought to start this thread to specifically discuss diabetes but with a focus on steroid induced diabetes.
Within 3 days of starting Prednisolone in late January my sugar went out of control and I was diagnosed as steroid induced diabetic. I had been on and off diagnosed pre-diabetic but managed to control it with diet and the last few years blood tests had been in the normal range.

It was decided with my own input to start insulin injections. I didn't want to fiddle around for months trying to stabilise on some other oral drug living with the high hope that once the pred was reduced or even discontinued the diabetes would reverse itself. I also felt that as the pred was going to be adjusted continuously it would be easier to adjust the insulin than oral diabetic medication.

Only issue was that I was put on Novamix which controlled the highs but introduced too many lows for my liking. I was constantly worried about hypos especially during the night and early mornings. The insulin was reduced when the pred was reduced however that then made the sugar jump far too high in the afternoon/evenings.

I finally managed to get hold of an Endocrinologist who decided that in my case the novamix wasn't the best option. Something I had been wondering myself as I figure with normal fast acting Insulin I could be more in control. So I am now on Novarapid which I take 2x a day. 8 Units after I take the pred with my lunch and 6 units after dinner.

But it's a learning curve for me. So I am doing very frequent measuring of my blood sugar with the aim being to get it to as normal a level as possible. Having the instant insulin here also means I can now reduce my carb consumption. I was eating cake and carbs around the clock to avoid hypos. Not great for the waist.

The cake weaning was a bit harder than I thought. Also because I stuffed up on Tuesday and was 8 hours late with taking my pred hence everything was rather mucked up.

Wednesday was my last day on Novamix and due to the very late (8pm) intake of Pred my sugar jumped to an all-time high before bedtime
Thursday I was surprised that overnight it had dropped to 6.6 which is close to normal for fasting (should really be under 6)
Thursday lunchtime it was 6.3. I had Chicken casserole and rice for lunch. 30 mg Pred and 8 units of Novarapid.
Here is how the sugar behaved:
5am 6.6
1pm 6.3 (before eating lunch and taking pred)
2.30pm 9.4
6pm 17.9 (regarded dangerously high) - before dinner
9pm 15.0 (I was initially told I must try to keep it below 14 however as long as it keeps dropping the Endo was not too worried)
3am (Friday) 8.6
So I wasn't too worried it being day 1. I also know what drove it up so high after dinner. I had some cake as afternoon snack. Bad time of day
for me to eat cake as it was also on top of the rice for lunch.
Friday was as follows:
5am 7.0
1pm 6.5 (before lunch and pred)
6pm 16.9 (after dinner and 6 units of Insulin)
9pm 16.6
11:45pm 9.4
Same transgression. Had cake in the afternoon

Saturday I behaved myself.
5am 8.6
1pm 6.8
6pm 14.2 (after dinner and 6 units of Insulin)
8pm 17.7 Now I worried and decided to take 2 more units of Insulin
10pm 14.8

By Sunday (today) morning it was down to 6.7

Strange thing I found was that the sugar was higher in the evening when I didn't eat the cake in the afternoon. All I can think is that on both previous days instead of our usual soup we decided on a toasted chicken or ham sandwich made with wholegrain bread. But it must be the bread was too high in carbs. Not sure will be tracking this a bit longer. But I think when the sugar climbs above 14 I will simply take 2 Units of insulin or 4 if it is much higher.

Ringing the Endo early next week to discuss progress. He may decide to increase the novarapid both at lunchtime and dinner time.

Anyway, thought for anyone else totally new to diabetes management this may be useful information. The units we use in Australia are different to those used elsewhere when measure Blood Glucose. Here are the recommended values explained:
Fasting - if below 5.5 no diabetes; if between 5.6 and 6.9 could indicate pre-diabetic and needs more testing; If over 7 it's diabetes.
Non-Fasting - if below 5.5 no problem. if between 5.5 and 11 more testing could a) decide no diabetes or pre-diabetic . if over 11 and fasting glucose tolerance test shows up over 7 then it's definitely diabetes.
I was told at the hospital to sing out when the blood glucose goes over 14 after eating. So at the moment that is the guideline I am using. If it is constantly over 14 after lunch and dinner I should probably increase the insulin.

The great thing with novarapid is I can sleep at night without worrying about hypos and go out in the mornings without worrying about hypos. It will also be very easy now to adjust the units once the pred starts coming down again.