Is steroid induced prediabetes harder... - Lung Conditions C...

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Is steroid induced prediabetes harder to reverse?

O2Trees profile image
51 Replies

Morning friends. Lovely autumn day here in Kent.

I have the above, also family history of diabetes, and am currently on a diabetes awareness course run by a private company on behalf of the NHS. I have halved my carbohydrates (having already totally given up all processed carbs like biscuits, cake, white bread and anything containing sugar) and am exercising more, and after eating which the course tells us is best for controlling blood sugar.

My last HbA1C blood test (it measures blood sugar in the blood over the past three months) was first week in August and blow me, it was exactly the same as the test three months previously.

Very disappointing especially when people I know with diabetes and prediabetes are getting great results with far less changes in their diet and lifestyle than I am making.

Hence my question in the post's title. I will also put this question on the diabetes forum but know there are some here with (pre)diabetes, as of course many have had to use large amounts of steroids like prednisolone in order to control our symptoms and basically to survive. Any thoughts welcome and hope everyone is doing well. :) :)

51 Replies
frose profile image
frose

I can't answer your question but im sorry to hear this. X

O2Trees profile image
O2Trees in reply to frose

Thanks forreplying anyway frose. Do hope you're doing ok xx

frose profile image
frose in reply to O2Trees

yes thanks, though i was made redundant last Wednesday. I'm more than happy to give up the struggle of continuing to work but as im 3.5 years away from retirement I now have to face the challenges of universal credit - yuk. But, life always has a way of working things out 😀 xx

O2Trees profile image
O2Trees in reply to frose

Really do hope something turns up. No joke having to wait 3.5 years for your pension. I was one of the lucky ones and got it at 60. No justice :( You take care, frose xxx

frose profile image
frose in reply to O2Trees

thank you xx

PaulineHM profile image
PaulineHM in reply to frose

Hi Frose, was thinking of you the other day, recalling when we walked the British Camp, nr Malvern. Do you remember ? I was up there walking,/crawling 😂 to the viewpoint.

Enjoy your retirement.

Good wishes,

Pauline

frose profile image
frose in reply to PaulineHM

Hello!

I do indeed - a very lovely day. I'm pretty sure it might be a challenge too far these days! I do hope you're keeping well 🙂 Not entirely retired as i have no pension so I'm hoping to turn my glass making into a few pennies!

sassy59 profile image
sassy59

Morning Jean, we have a lovely day here in West Sussex too.

I’m pre diabetic so am trying really hard to cut down on carbs, sugar etc. I want to lose weight because of my AF too. I can’t really answer your question but you could be right about the pred. Hopefully someone else will be able to help.

Take care xxxx😘

O2Trees profile image
O2Trees in reply to sassy59

Thanks for your reply Carole. I think losing weight helps so much but Im underweight and have to watch that. Afib is a horrid thing to have, so friends tell me. Love to you both xxx

sassy59 profile image
sassy59 in reply to O2Trees

I do struggle at times but keep going. You’ve done well to cut things out so must be disappointed that nothing has changed. Afib is horrible but I don’t suffer too badly at the moment.

Lots of love to you both too. 👍😘❤️

peege profile image
peege

hi, sorry to hear this especially after all your effort over 3 months.

I've pre or borderline diabetes 2 as well. I do rate Dr Michael Moseley and his well researched theories on diet for diabetes. He had diabetes as did his father however, he is no longer diabetic. There may still be his programmes on iplayer about it. I've got his book called the Eight Week Blood Sugar Diet book plus recipe book for the same, very good.

He's got a forum too. Good luck dear J ×××

O2Trees profile image
O2Trees in reply to peege

I have seen his programme and know of his books, P - I will order them. Feeling so disillusioned now but I guess sometimes we cant control everything, much as we might want to! Thank you so much for the Moseley reminders. You take good care xxxxx

PaulineHM profile image
PaulineHM in reply to peege

Hi, hi, how are you Pen ?

Pauline

peege profile image
peege in reply to PaulineHM

PollyP?

MMaud profile image
MMaud

O2Trees , are you still taking steroids, and if so, is that planned to continue into the future?

Steroids can literally be life savers, but they do tend to push the blood sugars up in varying degrees. Some find it doesn't make a lot of difference and others find their blood sugars go stratospheric.

There's no doubt trimming up, if you need to, and moderating your diet will help in your general health, even if your prediabetes can't be banished.

Many, many people live with prediabetes, without knowing. Obviously, you don't want to meander over the diagnostic line to full diabetes, but if you do, diabetes is not the worst thing in the world to live with.

Good luck with it all

peege profile image
peege in reply to MMaud

Occasionally I miss-time eating, my blood sugar plummets usually when im walkingLola. Get shaky, legs go jelly like and my head breaks out in a cold sweat. I try to keep glucose tablets in pockets & take snack out with me. It's a pain in the b*m.

I didn't know about the steroid effect on bloodsugar so I'll be keeping a closer eye on it. ××××

O2Trees profile image
O2Trees in reply to MMaud

Thank you for your encouraging reply Maud. I will be on my steroid inhaler for the rest of my life but trying hard to avoid pred and have been pred free for some time. Take care :)

Biofreak profile image
Biofreak

Hi O2Trees. Prednisone raises blood glucose in anyone who has to take it and is probably the main cause of your pre diabetes because your pancreas is working overtime to cope with the higher glucose in your system. So basically your pancreas is overworked trying to produce enough insulin to cope with it. I am type 1 diabetic and have to increase my insulin dosage when I need to take Prednisone. You are doing all the right things to try to reduce your blood glucose so it's not you, it's the Prednisone. I would speak to your doctor and maybe you might have to start taking some Metformin medication to give yourself some assistance in reducing your blood glucose. However, it's likely that if you didn't have to take Prednisone, your pre diabetes may reverse, at least to some degree.

O2Trees profile image
O2Trees in reply to Biofreak

Hi Biofreak - I just take my Symbicort inhaler for asthma and no chance of stopping that. But Ive had a lot of pred and IV hydrocortisone in the past though only a couple of weeks of pred since 2018. My test result is only 43 so some may think Im making too much of a fuss but with a strong genetic component I dont want to risk it going higher. It was just disappointing to have the same result over the last year despite changes in diet and exercise. But I may have to accept it.

Re medication (Metformin) my diabetes nurse mentioned a med which began with an I that you can take if you have to be on pred for some time and this is meant to control the blood sugar temporarily while you are on the pred. Wish I had written down the name. All the best to you. :)

in reply to O2Trees

Hi Jean. Sorry to read this. What an absolute pita.

I know someone on an “incretin mimetic”, could that have been what the nurse mentioned. They’re newer drugs than metformin, I believe.

I’m lucky in that although I’ve had masses of pred, esp in the last 5yrs, my blood glucose is still ok. But I’ve had to have cataract surgery on both eyes, and both times there were complications, so I’ve still got blurry vision! And of course my skin is dreadful, about 25yrs older than the rest of me 🤣 Pred is a mixed blessing and I think it’s dished out too readily. Like you, I try to avoid it if I can x

O2Trees profile image
O2Trees in reply to

I think we all try to avoid it but it seems a necessary evil at times. Sorry to hear about your eyes Hanne62. And my skin is a wreck too, worse on the left which I sleep on as it helps the reflux.

I'll check out that drug - I should have written down what the nurse said. Lovely to hear from you and take good care. xx

Biofreak profile image
Biofreak in reply to O2Trees

At a level of 43 you're not so bad only slightly above normal. I understand your frustration though after trying so hard.. Small world because I also use a symbicort inhaler. All I can suggest is keep doing what you're doing and it may be lower next time. Have a look at the Diabetes Uk site and see if there are any helpful hints there. Good luck x

MMaud profile image
MMaud in reply to O2Trees

You inhaler will have a marginal impact on blood sugars. The major impact is from the oral or IV steroids.

The IV wouldn’t be administered unless required, so unfortunately it’s a prioritisation game.

O2Trees profile image
O2Trees in reply to MMaud

I haven't had IV hydrocortisone since 2018 when i had a great deal. Since then just a very few week long courses of pred for my asthma. And the ongoing Symbicort which I have used daily since 1986 - and it does a good job. I know Im stuck with whatever I need at any one time.

PaulineHM profile image
PaulineHM

Hello 02, I became Diabetic after a terrible year for me back in 2016 when the asthma wouldn’t calm down at all and 9 months of Prednisone tipped the cells over the edge. Steroids cause insulin resistance in the cells…hence the jolly old blood sugar went sky high. Eye damage as well cause by the high blood sugar!

The first thing after a change of inhalers was to get off the steroids which I did by dropping 1 mg per week.. which took months! But hey I did it. The second thing was to change/modify the diet, doing pretty much the same as you dropping all simple carbs, minimising complex carb and indeed things improved. We still need some carbs otherwise the liver just pumps out glycogen into the blood stream, increasing blood sugar. Obviously exercising comes into the equation.

My HbA1c is up and down. One year it was a brilliant level but I was feeling cold and feeling grim with it. So it’s a balance isn’t it. Do your best I would say and don’t beat yourself up over it.

Have you looked at the Diabetes .co. U.K. Website at all ? That may be helpful. Do let us know how things go on for you.

Good wishes,

O2Trees profile image
O2Trees in reply to PaulineHM

Yes, I also have asthma and rely on a steroid inhaler which I will always have to use. I have had three treatments of IV hydrocortizone which is mega-strong but helped save my life. Well done you getting of steroids, especially after your bad year in 2016. But sorry to hear you have eye damage - is that glaucoma?

I didnt know that the liver pumps out glycogen without enough carbs. I understand from the web that we needs between 20g and 90g carbs a day. I think I eat around 110g but being underweight Im lost as to how to drop more as eating more fat to compensate doesn't appeal. There is a GP in a northern town (sorry cant remember which one) who makes youtubes about how he controls his diabetes using the keto diet but it seems risky to me.

Your advice about not beating myself up is helpful - I tend to go full tilt to begin with then when Ive learnt all I can, I incorporate it and relax. At present Im at the research stage and a bit manic. But posts like yours help so thank you and I hope you go on ok. :)

Ps: I have been on the diabetes.co.uk forum - will take another look.

PaulineHM profile image
PaulineHM in reply to O2Trees

Hi, no the eye damage was from steroid induced diabetes ( which I didn’t appreciate I had ) . Eye damage has resolved now and I am checked at the Diabetic eye screening every year. Even with a well managed HbA1c eye damage crops up now and again. My HbA1c last week was 44.

Russell Winwood, COPD athlete, advocates a Keto diet, mainly because carbs drive inflammation which doesn’t much help any of us does it? You can look at it, although it is very meat based and I eat hardly any meat. Lots of advocado ( good fats ) and cheese though. Keto as I expect you know is quite controversial across many health conditions. There isn’t one easy answer is there.

As my ACOS (Asthma OPD Overlap Syndrome) progresses I find it harder to retain the balance with the body. But never say never eh ?

Good luck with your research…

O2Trees profile image
O2Trees in reply to PaulineHM

So glad your eye damage has resolved. Glaucoma is in fact a side effect of steroids I believe.

PaulineHM profile image
PaulineHM in reply to O2Trees

I am not sure about steroids and glaucoma, however steroids definitely exacerbate cataracts! I had mine removed just before the pandemic.

O2Trees profile image
O2Trees in reply to PaulineHM

Yes, I did know that and hope your cataract removal was successful. I have them so the optician says but Im not aware of them. I do have early macular degeneration though. Hopefully that wont development enough to be a problem.

Lutontown profile image
Lutontown

Both my wife and I have recently been diagnosed as pre-diabetic. I have always had a sweet tooth, and my wife loves bread. I have been trying to cut down on carbs, and less sugar on my cereal. My wife and I have been using a nasal spray to combat stuffy nasal passages. It turned out that this contains a steroid, and since finding that steroids can induce diabetes, we have stopped using it. Just waiting to see if Part 1 test done last week gives a better result on diabetes after these small changes. The only thing is the main reason for becoming diabetic is getting older.....

O2Trees profile image
O2Trees in reply to Lutontown

Not much we can do about that is there?! I hope your test does show some change. What is a Part 1 test btw?

Lutontown profile image
Lutontown in reply to O2Trees

Just provided urine sample and blood. Don't know if there are any more "Parts" to come.

helenlw7 profile image
helenlw7

I was interested to read your post because I was diagnosed with steroid induced diabetes last week. My husband has been diabetic for many years so we already eat a fairly healthy diet. I’ve been referred to the diabetic education programme. I intend to start dieting when we get back from our holiday, but I find exercising painful, mostly because I’m waiting for a knee replacement.

O2Trees profile image
O2Trees in reply to helenlw7

It's so hard for people like yourself to be told to exercise when pain makes it very hard. I sympathise. Ive had a long reply from someone on the diabetes forum which I have to study more. One of the difficult things for me, and I also eat a healthy diet as in my post, is that Im slightly underweight in a typical emphysema way. Most advice about diet is about losing weight and I think if you lose weight that on its own makes a difference to your diabetic test results.

Good luck Helen, and if you every want to chat do message me. All the best. :)

helenlw7 profile image
helenlw7 in reply to O2Trees

My gp is completely understand my difficulties in losing weight, but the first orthopaedic consultant I saw said I had to lose 4 stones and be completely off the steroids! This was in 2018 and I weighed 12 stone, and I’m steroid dependent so can’t stop taking. When I said this he discharged me! About a month ago I went to a combined appointment with a rheumatologist and a different orthopaedic consultant, but from the same hospital as the first one. He examined me and said he’ll put me on his list when I’m ready. I asked about the steroids and he said I can keep taking the same dose, but they’ll do the op using an epidural so they can keep an eye on my breathing.

MMaud profile image
MMaud in reply to O2Trees

if your weight is low, up the proteins and fats in your diet.

Believe it or not, if your carbs are low it takes a while to gain weight ( if you want to).

Izb1 profile image
Izb1

Seems so unfair to not have any change when you have put so much effort into changing your diet, I can really sympathise with you. I would definitely talk to somebody and confirn if its steroid induced, there maybe different things you can do . I would also ask about chromium supplements. I wish you all the best x

O2Trees profile image
O2Trees in reply to Izb1

Thank you Izb1. I was reading about chromium the other day. Berberine is another thing meant to help, in fact to be as good as metformin in some research. Best to you too x :)

Izb1 profile image
Izb1 in reply to O2Trees

Worth checking out British Supplements, there are no fillers or binders x

O2Trees profile image
O2Trees in reply to Izb1

I dont know about British Supplements . . .

Izb1 profile image
Izb1 in reply to O2Trees

Type in Berberine in the google box and it will come up with a few different ones including British Supplements, check them out x

MMaud profile image
MMaud in reply to O2Trees

Metformin doesn’t make a huge difference to blood sugars, but it does improve insulin (natural or exogenous) sensitivity a little.

jackdup profile image
jackdup

I have had my pre-diabetes A1C go well into the diabetes range after having been on steroids but after no longer taking them it dropped back to where it was before taking the steroids.

O2Trees profile image
O2Trees in reply to jackdup

That's great jackdup. Unfortunately the regular small amount i take in my steroid inhaler seems to be the problem, along with genetic component. Hard to know which. And I cant live without my inhaler. Do you know how quickly your A1c dropped back after stopping the steroids?

jackdup profile image
jackdup in reply to O2Trees

That is a tough spot to be in where you can’t do without them but they are causing the elevated sugar levels. I’m not sure how much diet and exercise will help when continuing with the steroids but can well imagine it must be very disheartening to see no results from the exercise and diet changes. Have you spoke to a diabetic specialist to see what they might recommend?

Here they are only allowed to check A1C every 3 months. Mine was quite high and then at the next check 3 months later it was back to where it had been before. I can’t remember when I stopped taking the steroids in relation to the test that was high but believe I had stopped taking them by the time I had the elevated blood test, just can’t remember how long it was between when I stopped and when I got the high results but three months later they were back to normal.

watergazer profile image
watergazer

hi O2trees. I am the same as you When I initially started the pre diabetes course I lost weight and my blood sugar level reduced however on the next blood test mine rose whereas the blood sugar levels of others in the group who were doing less exercise and eating more than me had carried on lowering. I was so upset. Like you I can’t afford to loose weight I continue to struggle and I’ve decided it’s my inhaler and occasional steroids that are doing this to me.

I did a week on a 1000 -1200 calories, low carb diet (30 g a day)&reduced my inhaler by 1 puff a day and in that week my levels went from 48 to 46. I am continuing the reduced dosage hoping it can keep my blood sugar levels down. My next HbA1c is due in January Fingers crossed.

I get so down about my blood sugar levels as I’ve cut down on carbs and walk a lot.

🤗🤗🤗

O2Trees profile image
O2Trees

Oh I so empathise watergazer. Our situations are so similar. Im trying to work out how to just eat 30gram a day and I think I will have to cut root veg and the tiny amount of whole grains I eat - which Im told are important for the fibre. Lets hope in January you see more improvement. Take care :) :)

TeaToasty profile image
TeaToasty

Similar scenario as you. If you are interested in supplments, I've used the herb gymnema sylvestre with some success, after not tolerating metformin. My doctor approved it. Also of note, statins for cholesterol is associated with developing pre-dm and diabetes. I've also learned you can temper an sugar spike with carbs by always consuming a healthy fat and/or protein with it.

Hope this helps in your developing tool box of ideas. So many helpful kind folks here.

O2Trees profile image
O2Trees in reply to TeaToasty

Thanks so much TT. I am collecting a toolbox, its true! Take care.

MMaud profile image
MMaud in reply to TeaToasty

Eating fat (and to a lesser extent, protein) with carbs will slow the blood sugar rise, but the net impact is usually the same. By that I mean either a short time rise to x or a longer duration rise to y.

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