As if PC isn’t enough now my Glucose is climbing. Just four months after beginning Zytiga & Prednisone my daily glucose has risen and my A1C has gone from 6.5 to 8.0. I have been steadily increasing my daily insulin (Lantus) from 12 to 16 units to compensate but that is obviously not enough.
For those of you in the know; is this to be expected? If this is a common occurrence how is the problem addressed? Just titrations my insulin until glucoses are back in line? I’m sweet enough so I need to lower my glucose. Thanks in advance for any of your pearls of wisdom.
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See my answer below. Its nothing much to do with PC drugs. It takes at least 20 years to get prediabetes and diabetes. Its everything to do with carbs and a bad diet. Get a HB1A test for yourself.
Kind of a stale thread, but that is just not correct. A simple Google search will show that ADT effects metabolism and studies show increases in a1c within 4 months of starting ADT. Your advice below to follow a diabetic friendly diet, such as low carb, is solid, but you can't outright dismiss ADT as the cause for some people.
Yes soorry to say...lupron is known to raise a1c by atleast 1 point i was in same boat had kept mine below 6 for years bfore apc...now i try to keep below 7 ..im on lupron and erleada....if you dont take actose ask for generic it will lower it..i do it and metformin...and there are those in her who think metformin is a help against pc....but i dont....i took it for years ...and here i amBw.
Thanks. I’ve been taking Metformin for years too and here I am. 😏 I think I need to rework my menu and exercise regime. Sucks getting old and having PC!
Some men have so much muscle loss and back pain exercise is difficult. Granted his diet could stand improvement! You can lead an old man to veggies...you can't make him eat!
I forgot to mention...my husband takes insulin in the morning and before bed. He takes Humalog before each meal that contains carbs, metformin daily and Ozempic weekly. He also has a glucose tracker so that he can monitor his glucose level without having to stick his finger 10 times a day. With all this, and eating somewhat healthy, he was able to keep his A1C around 7 when he was on Zytiga. I say "was" because he is off Zytiga now, but has had to increase his prednisone to 80mg so his diabetes is a bit out of control again.
A tendency towards worsening metabolic syndrome is just one of the symptoms of ADT that can be (at least partially) addressed with changes to the regimes of diet and exercise. So perhaps explore that, as well as changes in medications (which might include the addition of low-dose transdermal estrogen).
Yes my hubby is type 2 and MO told us that med combo could increase blood sugars so we elected Xtandi. It only worked for a couple months though and the side effects were much worse than the Eligard.
I've been on Orgovyx nearly a year, since August 23, 2021. My glucose level has gone DOWN since I started Orgovyx.
I have gone from worrying that it was becoming too high, at 106 mg/dL, to starting to wonder if it was getting too low, at 75 mg/dL. I have not changed my diet or exercise routine, so I'm not sure what accounts for the drop. Neither does my MO.
If it is type 2 DM then discuss adding semaglutide weekly (oral or sub q). 80 mg of prednisone is obviously going to make control more difficult. Why does he need to take that much?
My husband is taking 80mg of prednisone due to an undiagnosed issue thought to be brought on my Keytruda. We see his endocrinologist tomorrow, but the MO thinks it may be hypophysitis. One infusion of Keytruda brought his PSA to undetectable, but his thyroid or pituitary (or both) are very unhappy right now.
It is complicated that's for sure. What works for one may not for another. When using all these medications it messes with everything in your system. I have a friend with breast cancer, she is thin, always eats very healthy and exercises. There are no guarantees. Some very healthy people get and die from cancer
Your best option is healthy eating and exercise. Shortly after ADT start I began walking and not too strict Mediterranean diet. Lost 50 pounds and A1C is 5.7. Starting weights soon. You will feel better and might even live longer.
By not too strict I mean cut out all of the white stuff—sugar, potatoes, white flour, rice and pasta and eat lots of grease fruits and vegetables and whole grains. A piece of cake is ok once in a while, but don’t make a habit of it.
I know these things but have been too busy ( lazy ) to implement them. An A1C of 8 is a good motivator. Thanks for reminding me of the things I need to be doing.
My husband has been a diabetic for many years. Hard enough to keep it under control before the PC. Taking Enzalutamide caused a poor appetite and rapid weight loss. Finally, convinced his MD that he needed to adjust his insulin with the weight loss as the Urologist blew it off. Also, his MD said his A1C was too low (6.1) and making his body think this low was the new normal for him. His goal is now to just stay around 7. Made adjustments a couple times as he was having low glucose levels too often. Definitely talk to the doctor about insulin dosage needs now. Most of the hormone treatments I have read about will interfere with diabetes. Sometimes our Urologist seems unwilling to see the see the connection. Heart, kidney disease, diabetes AND narcolepsy sure make the PC treatments much more complicated. Treating the whole patient and not just the PC takes much more effort. But the whole patient has to be taken into consideration. Good luck.
I'm also worried about diabetes using Zytiga and dexamethasone. Currently prediabetic. Have researched progression. You must lose weight fast. See Dr Ben Bikman, Youtube, also Jessie Inchauspe. Both are research scientists, and have written relevant books. Namely, Why We Get Sick, and Glucose Goddess respectivly. Also, Dr Lustig who is a world expert, has also written Metabolical. I have followed J Inchchauspe. She recommends vegs first, then fat with protein, followed by carbs dressed with fat. Also, full fat milk. I lost 10kg in 10 weeks, still losing weight. I'm never hungry. I definitely recommend your own research. Good luck!
A healthy, common-sense diet... good advice. Sounds like you are on the right track. Everything certainly works better with a patient who does their part to help themselves.
A low carbohydrate diet helps in reducing insulin requirement and hence also regulation of sugar levels. This means, as mentioned earlier in one reply. cut out the white stuff. No sugar (of course),wheat flour, oats, and any other high carb cereals and food products. One need not be totally zero on carbs - maybe 50 gms or so a day should be enough. I had prediabetes for almost 10 years or more. I have gone from HbA1c of 6 to 5.1 in 9 months. My fasting blood sugar is below 90.
Sorry to jump into your post but looking for a good glucose meter and supplies and having a hard time finding a good one, so many to choose from but also bad reviews. Any suggestions on the brand you guys settled on? Thanks
Our insurance company provided my husband with a Freestyle Libre 14-Day. It isn't particularly accurate (+/- 20%). He is very happy to have it though. He only sticks himself first thing in the morning and before bed at night, and of course if the Libre shows a reading that is within 20% of dangerous. The good thing about the Libre is that you can see if you are trending up or down. My husband finds that very helpful. Changing the sensor every 14 days has not been a problem. Good luck in your search.
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Zytiga and diabetes
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