Prednisolone and type 2 diabetes

I have very recently been diagnosed with type 2 diabetes (2 days ago)

I take my prednisolone at lunchtime as it suits me then. However when I test my blood sugars about 4 hours later my levels are in the 20s where they are about 8 in the morning.

Should I take my prednisolone at a different time as I believe it is pushing up the blood sugar levels. I am thinking straight after the morning test.

11 Replies

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  • Hi,

    Pred can raise blood sugars, unfortunately it's a common side effect even for those who are already diagnosed diabetic. As yours has recently been dx it may well be Pred induced, and should improve as you reduce the steroids.

    My hubby was diabetic, so I have some second hand experience of the problem- his levels were higher at different times of day, depending on may things. Guess your morning readings are before eating, so should be low. Then do you test before evening meal, and again before you go to bed? What are evening readings?

    It is recommended that Pred be taken in morning, but if that's what's causing a high reading it will still happen, but at lunchtime, so you're just shifting the time. You could try splitting your Pred, so long as that doesn't prejudice your PMR, a lower dose may not make your sugars spike so high. Can you discuss with diabetic clinic, if you have been referred to them?

    Sure other diabetics will be along shortly with advice.

  • hi, I was told to test pre breakfast and later in the day. Yesterday I tested in the morning and it was 8.8 and then tested at about 5.45 and it was 25. That was before my evening meal. I had my Prednisolone at about 1 pm. I have had it with breakfast today to see if there is a change.

    I think I have had a bit of a flare as I have more pain but can cope with it as don't want to up dose as this may confuse me even more with my levels! It was a shock. I had been to gynaecologist and take ma urine sample. The gynaecologist told me I had glucose in my urine and sent me for a blood test. Then in the evening the hospital rang and said my blood sugar was 28 and after some consultation (because I had no symptoms) told me to get an urgent appointment with the doctor the next morning. This caused a fair bit of stress!

    I will ask the diabetic nurse at my doctors about how the Prednisolone affects the blood test when I go to see her in a fortnight.

    Thanks for your help

  • Pred triggers the liver to release spikes of glucose into the blood - they can be random but they are likely to increase levels after meals.

    You really do need some discussion with the diabetic clinic - it can be difficult to manage BS levels when on pred.

  • PMRpro and Koalajane: Oh wow! Thank you. I did not know that Pred triggers the liver to release spikes of glucose into the blood. My blood glucose level rises 50 to 60 points during the 6-7 hours after I take the Pred. Then it goes down. (In the US the glucose meter reads about 100. Less than 100 is OK. More than 130 or 140 is not OK.) I did not know what was causing it. Now I do. I try to start the day in the 70s or 80s. That way the rise does not put me so far into the stratosphere. But this requires extremely conservative eating regarding high glycemic foods and grams of carbs. Also a half hour on the treadmill (or walking anywhere) drops my blood glucose level. Finally, I have learned that muscle mass absorbs more blood glucose than non-muscle mass. So when we are well enough working out with a few weights can't hurt. That said you have to be well enough to be up and about to do all of this. Managing this disease is a full time job.

  • Hi KJ

    From the point I was put onto prednisolone (4 yrs ago) I was told to check Blood sugars 4 times daily and moved from tablet-control to tablets and Insulin. Following months of to-ing & fro-ing I was informed that my Diabetes was "fragile" and given a regime whereby I took the amount of insulin necessary to keep a balanced BS level. In the earlier days levels were about 20 but my current HBA1 is 8.2.

    One of the biggest lessons is testing before food, only eating simple food when you take pred and recognizing the level of insulin needed to keep to the desired levels of BS. The only way to do this effectively is to keep accurate records of how much pred affects BS levels, whilst also monitoring which other foods cause spikes. And they're not always the obvious ones!

  • Hi Koalajane,

    I was diagnosed in January with steroid induced diabetes. I have PMR and GCA and have been on steroids for many years. I tried at first to manage it myself, strict diet, fasting for 17 hours a day, taking herbal supplement Berberine. Yes it all helped but not sufficiently to get my blood sugar numbers lower enough. Hence I am now taking Metformin 500mg twice a day. Metformin shouldn't be taken at the same time as steroids or diuretics, so I space them out. I take 12mg Prednisolone daily in split doses, I find it's the only way I can keep my steroids this low. Any lower and I trigger a GCA flare up. I do my blood sugars twice a day, before breakfast and 2 hours after my evening meal. Average results in January showed 8 pre breakfast and 20+ after evening meal. Current average 6 pre breakfast and 9 after evening meal, still higher than ideal but much better. I have noticed it is not always influenced by food intake but how I am eg not sleeping because of pain, stress etc. Hope this helps. I joined Diabetes UK to get the best information. Take care.

    Love

    Margaret

  • Thanks a lot. Yes this does help. My test lecvels are practically the same as yours were in January, this is after taking gliclazide for 3 days. They are going down slowly. Is this what happened with you? Thanks for replying

  • Can I take gliclazide and Prednisolone at the same time?

  • Hi Koalajane

    Sorry but I am only taking Metformin not Glyclazide. I would check it out with your Pharmacist.

    Yes my blood sugar is improving thank goodness but it is not an exact science. Steroid levels, stress and not sleeping all impact on my blood sugar levels. Some things are very difficult to manage.

    Margaret

  • So was so pleased tonight as my pre dinner test was 13 which was good after being in the 20s. I have read the patient leaflet in both the gliclazide and the Prednisolone and it says nothing about not taking them together. Thanks for your help

  • You are very welcome. Please keep in touch if you think I can help.

    Margaret x

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