Seretide and blood sugar rise

[Kati66]

Hi all

About four months ago I developed asthma symptoms at night so saw the asthma nurse at my surgery. She put me on Montelukast initially and I was on that for three weeks. It helped with the asthma issues but left me feeling very low and I had a few instances of seeing things!! Very scary! So now she has put me on Seretide inhaler which I’ve been on for a few weeks. I’ve not noticed it helping my nighttime asthma as yet but my blood sugar readings have increased a fair bit(type 2). I’m seeing her again on the 20th so will discuss with her then.

Has anyone else experienced blood sugar highs whilst on this drug?

Thanks , Kati

[Poobah]

Seretide contains a steroid medication, as do most preventer inhalers. Steroids will affect your blood sugar levels to some extent and that differs from person to person. These combination inhalers are the main treatment for asthma (they also contain a long acting bronchodilator), so there's limited alternative treatments for your asthma nurse. Montelukast is usually an add on treatment rather than a primary one, but considering your diabetes, your asthma nurse was probably trying to avoid the steroid unless absolutely necessary.

It might be beneficial to telephone the helpline and talk to one of the Asthma UK nurses, who are very helpful, to see what your options are and to understand how to balance the care of both your diabetes and asthma.

Helpline: 0300 222 5800, open Mon to Fri, office hours.

[Kati66 in reply to Poobah]

Thanks for the informative reply, I think calling the helpline is a good idea as I'm not seeing the nurse until the 20th.

[JumpJiving]

 Kati66 What strength of Seretide are you on? How many puffs per day? Have you been given a steroid card to carry with you?

If the Seretide is affecting your blood sugar levels, as  Poobah said, the steroid content may be the reason. If it is, then it would be worth having your early morning cortisol level checked with a blood test, and potentially moving from Seretide to something less potent such as Alvesco or Fostair. Speak to your asthma nurse or respiratory consultant to see what they advise. With the Christmas period coming up, I'd do that before your planned appointment if possible.

[Kati66 in reply to JumpJiving]

Thank you for the reply. The inhaler is Seretide 125 - two puffs twice daily. I did wonder if it was the steroid as when i was on Prednisolone last year, it badly affected my sugar levels and I had to take Glicazide to lower the sugars while I tapered down the steroids. I have been on Fostair for a couple of years but I started getting nighttime asthma symptoms and breathlessness at night. I haven't got a respiratory consultant, just the Gp asthma nurse.

[JumpJiving in reply to Kati66]

Kati66 Please do ask your GP (or the asthma nurse) about the early morning cortisol blood test. The combination of steroid-based inhaler + prednisolone last year (at a dose/duration that required tapering) does mean that you have been getting a level of steroids that increases the risk of cortisol-related problems. It doesn't mean that you do have them, but worth checking/monitoring.

[Kati66 in reply to JumpJiving]

Agree, it would certainly be worth checking the cortisol levels. I’ve spoken to the asthma uk helpline and an asthma nurse. She’s explained more about the differences between the inhalers I’ve been on. I’ve written down some tests that she feels should be done. Hopefully the nurse at my gp is happy with that 🤞🏻🤞🏻🤞🏻

[Motorman]

Your side effects re: Montelukast are similar to mine. Do a google the side affects are a bit scary! I am not taking it for now and sleep better. MM

[Kati66 in reply to Motorman]

It was very scary when I saw a face looking in the window at me! 😱😱

[Motorman in reply to Kati66]

I saw a face too! Mine was a scary grinning ventrilaquist dummy sort of thing. I swiped at it and it disappeared, dreams were very vivid as well. Since stopping montelukast I am OK, just daydreaming now

[Kati66 in reply to Motorman]

Oh those nightmares were awful!! I normally have very vivid dreams but taking this certainly increased that! Hope you are doing okay now and on some meds that help 🤞🏻🤞🏻🤞🏻

[Motorman in reply to Kati66]

Just on Fostair and Spireva with a rarely used salbutamol, no more montelukast if I can manage it. I take Loratadine as a anti histamine as well. MM