Steroid induced diabetes

[nannyjc]

I have presented my many chronic conditions to you before, all of which are due to prolonged steroid use. My new problem is possible diabetes, which I believe is also steroid induced. I go to Weightwatchers, eat a fat free diet due to gallstones, and avoid sugar as much as I can. The only thing left is to live on lettuce leaves!!! Your thoughts please.

[PMRpro Ambassador]

You say "possible diabetes" - on what grounds?

[nannyjc]

I had a blood sugar test as part of my normal annual health check, and the reading was 43. The level for diabetes is 48. I've had a re-check this week and awaiting the result. The Nurse wanted me to join a group with weekly sessions for nine months so she must think I'm heading that way.

[PMRpro Ambassador in reply to nannyjc]

A single random blood sugar reading is meaningless, particularly when on pred - you need to have an Hba1c check which is a reflection of the previous 3 months average BS level.

Taking pred can lead to violent swings in blood sugar levels which aren't always related to what or when you have eaten - if you are having one that coincides with your blood being taken it looks worse than it really is. There has been an intriguing thread on another PMR forum where a diagnosed diabetic has been monitoring his blood sugar closely. There is no rhyme nor reason as to the timings of the spikes! However - doing exercise

If you are interested, if you go to this page you should be able to look at his series of posts about what affects his blood sugar levels and the relationship to exercise.

patient.info/forums/profile...

[DorsetLady PMRGCAuk volunteer]

Hi nannyjc,

My sugars were a bit on the high side when I was on Pred, referred to the Doctor as pre-diabetic, but he was not too concerned as I was getting towards the end of my time with steroids. His view was/is - don't get into a panic about things, just monitor it - and take action when and if it's definitely diagnosed.

As your reading is below the level, then I know he would say you are pre-diabetic, NOT diabetic - but others may disagree!

[nannyjc in reply to DorsetLady]

Thanks for replying. My rheumatologist thinks I will be on 5mg steroids indefinitely because as soon as I try to reduce my symptoms return.....even after 61/2 years. Oh yes, I'm sure I'm pre-diabetic but I just wondered if anyone else has steroid induced diabetes.

[DorsetLady PMRGCAuk volunteer in reply to nannyjc]

Sure lots of people have. Hopefully they'll be along to advise.

[11caroline29 in reply to nannyjc]

Hi nannyjc. I was diagnosed with steroid induced diabetes the month after I started steroids (40mg). The first year on steroids was very difficult to reduce my blood sugar levels despite change of diet and 2 different diabetes medications 3 times a day. However once I reduced to about 13 mg my blood sugars reduced along with blood pressure and cholesterol. All these things were normal prior to steroids. However steroids did save my sight and do help with the pain with PMR. My neurologist seems to think I will be on steroids for life so just need to accept that and live with the many side effects and Diabetes is just one of many.

[nannyjc in reply to 11caroline29]

Thank you for caring. My list of steroid induced problems is so long I really do not want to add diabetes to it!!

[Rose54]

Hi

Diabetes runs in my family so I have always been very careful however blood sugars are very high at present .

Can I ask if you eat a lot of fruit I know I did on Slimming World however since stopping eating fruit I have lost a few pounds and sugar levels gone down slightly.

Rose

[PMRpro Ambassador in reply to Rose54]

Fruit, lovely and healthy though it is, does have a lot of sugar and however you want to look at it: sugar is sugar when it comes to carbs, weight gain/loss and blood sugar!

[nannyjc in reply to Rose54]

Thanks. Yes I do eat a lot of fruit, in preference to other high Smart Point snacks. I will take advice.

[PMRpro Ambassador in reply to nannyjc]

Apples, bananas and grapes are particularly bad in that sense - berries are better. But carrots and cucumber peeled and chopped into sticks and kept in a box in the fridge are better to snack on. Of course - by far the best is to learn not to snack and restrict food to mealtimes.

Often if you feel "hungry" you aren't really, you are thirsty. A good habit to get into is to get a drink first and go and do something else - 15 mins later you may well realise you aren't hungry any more! And of course - drinks shouldn't be fruit juices or sweetened. Water is best or teas without any sweetener - even artificial ones can induce insulin spikes.

[ayoung]

What are the symptoms of diabetes caused by prednisone?

[HeronNS in reply to ayoung]

Your doctor should be monitoring your sugar levels and if they become raised doing more detailed testing. If you are being properly monitored and cared for you shouldn't be aware of any symptoms.

[mega in reply to HeronNS]

My doctor has never routinely monitored anything to do with my GCA. It was diagnosed, in the end, by an oncologist and I wasn't referred to a Rheumy for 3.5 years. My doc. did do bloods when I could intermittently drag myself to the surgery but never suggested I should make a further appointment. Reading this site they appear to have been very high too, even after getting a small reduction of my steroids. I experienced awful dizziness, several times culminating in passing out completely on occasions, a couple of panic attacks lasting hours and even an hallucination involving a spider, about which I have a real phobia. Hither-to I'd had a reputation as a coping, cool-and-collected type. I am 77 now and the sheer effort involved in summoning the (non-existent) energy to be at the surgery certainly reduced my visits! In between visits for other issues and hospital visits.

I have never had any issues with sugar levels - I presume that was tested! With my overwhelming tiredness, though doing virtually nothing, all 'they' can come up with constant tests for anaemia which show that I have TOO MUCH iron in my blood - not enough to do anything about though!

Heron NS - I mean no criticism of your remark, in fact I entirely agree with you. It just didn't happen with me. Maybe it really is an ageist thing! After nearly six years I do have some days when I feel so much closer to normal so here's hoping! It can certainly be a long, lonely journey.

Warm wishes from me to all the PMR sufferers and, particularly, the GCA-ers.

[PMRpro Ambassador in reply to ayoung]

HeronNS has said it - although if your GP isn't checking bloods every 3 to 6 months (which is probably enough) and it does happen then the usual signs apply: being thirsty and needing the toilet a lot especially at night is common. But the trouble with diabetes is there aren't many symptoms which is why it is often missed.

[nannyjc in reply to ayoung]

Hi ayoung. I don't know what the symptoms are, as I haven't got any. The only intimation was the result of the blood test