prednisolone use

[Sureshj]

i hv been using prednisolone 5mg for my RA. This is increasing my diabetes sugar levels which are not getting cotrolled.

My doubts are

Can I use prednisole 5mg for ever.

Shd I taper down prednisole if I can bear the pain. or even though ucan tolerate pain ,does it have long term effects on joints degeneration.

Shd i reduce prednisole dosage or not - which option is less damaging

[sylvi]

Only reduce your drug on drs or rheumy consultant. Be prepared to find out you will need to go back on them I am on 5mg and i have been on this dosage for years only being increased if i have a infection.xxxx

[Runrig01]

Definitely don’t stop them without discussing with your Dr. I developed life threatening adrenal insufficiency from being on steroids. It was diagnosed when I had a severe stroke, which was found to be due to an adrenal crisis. I firmly believe if there is another option, then choose that. I was on 4mg when I had my stroke. I had no choice, I was initially prescribed for polymyalgia where steroids are the only treatment. Adrenal insufficiency has turned my life upside down, good or bad stress can suddenly make me nauseous, give me headaches and lightheadedness, as well as drop my BP. I need to then urgently takes tablets, or do an intramuscular steroid injection, to prevent it going on into a crisis.

Long term steroids are also not good for bones, often causing osteoporosis, and they can cause tendons to weaken and tear. If you are planning on reducing I’d ask for an early morning blood cortisol between 8-9 to check your adrenals are capable of producing their own cortisol, as steroids switch the HPA axis off, and the adrenals stop producing, because they see your getting enough from the pred. The symptoms I had leading up to the stroke were weight loss without trying, dizziness, inability to deal with stress, as well as the ones I mentioned above. My intention is not to scare you, but it is a side effect that’s often not discussed. Family had to be trained how to inject me when needed.

[helixhelix]

what other drugs are you on for your RA? You need to talk seriously to your rheumatologist about the risks, even tho’ 5 mg is not that high it would still be better to use something else.

But don’t stop until you have discussed with doctor!

[Pythagorus]

Definitely don’t stop the pred but all the questions you have written here put to your consultant. He is the one who knows your history and can advise you

[Kati66]

Hi Sureshj,

I was on prednisolone at the start of the year for about six months. My blood sugars went high and I mentioned this to the gp. He put me on Glicazide (think that’s how it’s spelled) which reduced my sugar levels. I tapered off the prednisolone eventually and came off the Glicazide, which did its job.

It might be worth speaking to your gp to see what they suggest. Xxx

[ranne21]

Can you speak to your hospital diabetes clinic, or at least the GP, about adjustments on a temp basis simply to help with your blood glucose levels? I’m not sure if you’re Type 1 or Type 2 but I’m T1 (insulin dependent) and my glucose levels went significantly high on Prednisolone. I had no guidance on how to deal with this and had to phone the diabetes clinic urgently for help. They were very familiar with the issue and helped me to sort it out.

[Deeb1764]

I have to be on 10mg of pred and I have diabetes 2 and the only way I can control the diabetes is by being strict with carbs and sugar. Its not a diet its just thinking what is best for me and making sure I understand what is ok and what is bad. Bad is rice for instance and now only have this once a week not 3 times.

I went from 67 level to 41 in 3 months by being tough with myself as I know i need the pred so it has been a conscious decision to change my food ways as though pred not been great for my body and causing other issues I cant go back as such! Think of rock and a hard place comes to mind.

Plus I now take Metformin to help the levels of diabetes BUT I can now reduce this as bloods sugars a tad healthier.