Blood sugar increase

[Lily2019]

I discovered that my glucose level went up from 6.7 mmol/L in Nov 2022 up to 9.1 mmol/L now. At the same time, but Creatinine went down from 47 umol/L to 39. My doctor said I should reduce Prograf from 1mg morning and 1mg evening to 1mg morning and 0.5mg evening. And also that I should reduce my Prednisolone from 3/4 of 5mg tablet to 1/2.

I'm worried that it could mean I'm on the verge of diabetes, although online it says that values over 11 (for glucose) for extended periods of times indicate this, so maybe I still have a chance to fight it? Diets, moderate exercise, yoga, some herbal treatment?

Any advice on how to deal with this situation is most welcome! 🙏

[Darlenia]

Hi! I'm the spouse to man who lost his kidneys to T2D, went on dialysis, and now has a transplant. The meds you are on will definitely increase your risk for diabetes if you are prone to that condition. At the time my hubby was on dialysis, he managed to rid himself of all meds for diabetes - he was on a normal diet. But immediately after his transplant, his diabetes resurfaced with a vengeance. This was due exclusively to his immunosuppressants which are essentially the same as yours. The good news is that they've lowered them for you - you're fortunate! So that should drop your glucose levels substantially. You can check your glucose levels to see how that's going daily if you want; glucose readers are available over-the counter everywhere. Otherwise, you can wait on your labs to see the results there (glucose and A1Cs). I honestly think they will drop for you.

Should your glucose remain high, then diet can help a lot to control glucose level - namely, limiting sugars and carbs. Many of those, of course, are found in processed foods, so it's best to rely on fresh veggies and fruits (particularly the berry types) and proteins (we prefer chicken and fish, etc,). We also swap cauliflower rice for rice and potatoes, use spiralized zucchini for noodles, etc. We've become avid label readers - sugars and carbs are always listed there. (You may need to deduct fiber from carbs to get the net carbs.) And, of course, there are also meds that can be prescribed by your team. Sadly, my hubby is on insulin. It's great that you're aware of the situation - because it takes a long time (often years) for glucose to do it's damage, many sweep it under the rug. Much respect to you for keeping an eye on it. See what happens! I hope you'll be pleasantly surprised by the outcome.

[Lily2019 in reply to Darlenia]

Thank you so much, Darlenia! I guess I have to become avid label reader too, after all. I've tried OTC glucose reader once just before getting my lab tests (which included glucose), and it was off by like 3 points, which kinda made me doubtful about it. But I will try the diet though, but I am vegetarian, so guess will have to replace chicken with something vegan-ish or some sort of nuts. Again, thank you so much for you reply, and hope the best for you and your husband!

[Blue-Quilter in reply to Lily2019]

The finger stick and blood draw glucose readings will always be a bit different. Three points is nothing to worry about!

[LisaSnow]

Modification on diets and regular moderate exercise definitely will help. I would check with your transplant pharmacist before taking any herbal supplement as any herb and tea has potential to interact with your medications resulting in adverse effects.

[Lily2019 in reply to LisaSnow]

Thank you, LisaSnow! I'm definitely starting to get more active these days (especially with cold weather gone and everything). Trying diets too. In herbal supplements, I believe nettles is most advised one? I've read about it, and I don't think it has much interaction with immune system, so I'm willing to try it.

[LisaSnow in reply to Lily2019]

I don't take any herbs personally. A quick review shows nettle tea consumption can affect the levels of a number of drugs including diuretics, ACE inhibitors, beta-blockers, calcium channel blockers, diabetes medications, and medications that affect estrogen levels. It may not be harmful.to you. But just to be safe why not confirm with your own doctor?

[OperationKidney]

I have the same issue with my Tacrolimus and Prednisone causing type two diabetes. Diet and exercise help a lot! I caught mine after it was too late, but have since been on meds that have made it easier to manage. I really wish us transplant folks didn't have to deal with these types of issues, it is so frustrating! Wishing you all the best 💚

[Lily2019 in reply to OperationKidney]

Thank you so much!! My mum actually had diabetes, so I'm susceptible, though your words kind of encouraged me, plus Google says 7 to 11 it's prediabetes, so in best case I should be able to reverse it, in worst case, atleast try to keep glucose levels not going up. Wishing you the best aswell! 💜

[Darlenia in reply to OperationKidney]

Yes! Transplants are treatments. As with all treatments, there are areas that need further improvement and attention. It's sad, actually, to give a person a priceless gift accompanied by a new condition, diabetes, that is harmful not only to it but to the whole body.

[OperationKidney in reply to Darlenia]

Amen to that, and then also to make it the patients problem to fix instead of fixing the medications and their side effects.

[Palmtreeguy]

Not an uncommon situation. In my case, my doctors prescribed Metformin. Problem resolved.

[LisaSnow in reply to Palmtreeguy]

Yes, diabetes is much more easily treatable than kidney failure. With medication control and healthy life style (which many don't recognize the importance of until becoming ill), one can live a normal life with high functioning. On the other hand, loss of kidney function and associated treatments are linked to much higher morbidities and mortality rates. Life isn't perfect but we can all make choices to make the best out of the situation.

[Darlenia in reply to Palmtreeguy]

Please be very mindful of the diabetes. Even with Metformin, it can make inroads on your health. My hubby's kidney failure was caused by diabetes even though it was "controlled". Most people rely on the A1Cs which simply is an average when I suspect it's the cyclic high-highs and low-lows that happen daily may be the culprit with diabetics. It generally takes a decade or so for diabetes to wreck havoc on your body, so that's "good" for your new kidney. However, if you had diabetes prior to transplant, other organs like your very important heart, may have had additional exposure. (Most with diabetes pass away from cardiac issues.) Immunosuppressants truly have a negative aspect to them.

[LisaSnow]

COVID infection has been found to increase diabetes risk also. It is simply best to continue on protecting ourselves against being exposed to the viruses.

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