Fatigue and diabetes

[Cobnut]

Heklo everybody

As someone who has been taking quite high doses of pred for two years I have now been told that my glucose levels are too high and must definitely take Metformin twice a day. My mother had GCA and diabetes so I was not surprised. When reading up on diabetes on the Diabetes UK website I was interested to learn that one of the symptoms is fatigue after meals if you have sinned and eaten the wrong food. As someone whose fatigue happens between 10-11am and 2.00-3.00pm I'm now wondering if fatigue caused by pred is actually a symptom of diabetes. Today I had porridge and yoghurt with some blueberries which I did not think was bad but I'm feeling extremely tired as I write this. Has anyone else noticed their tiredness happens at the same time. Its useful to plan your day but not if you are out and about. Also are blueberries banned if you are diabetic. I know that some of you have developed steroid induced diabetes. By the way I'm down from 40mg of pred to 8.5 and feel like a different person without the brain fog. I'm getting ready to drive the car again after two years - its scary. I did not feel safe on the roads without my brain being totally engaged and my eyes blurry. I often wonder how many people do drive when feeling like that. I live in the country and lucky that my husband does not mind being my chauffeur. It must be very difficult if you live alone.

[piglette]

One of the symptoms of auto immune diseases in general is fatigue, so the chances you will have fatigue anyway is likely. In fact most of us feel a bit more tired after eating as our body has to leap into digestion mode. Have you drastically changed your diet when you were diagnosed with PMR? It is really worth it. You may find that you will not need Metformin on a really good diet.

[Cobnut in reply to piglette]

Hello

I have been sticking to a low carbohydrate diet with no sugar but more fruit and salads as suggested by the hospital doctor but the glucose levels continued to rise. I have actually lost a little weight over the two years since diagnosed with GCA. I am hoping that when I get down to a lower dose of steroids I may be able to reduce the Metformin but as it has been difficult to reduce the steroids without flare ups, I am also taking Mycrophenolate. I am aware that fatigue is part of the illness but mistakingly thought that when it was under control the fatigue would get better. As I'm sure others are aware, it is very difficult to dish up healthy food to husbands who love the opposite. He is wonderful at undertaking the household chores but draws the line at lentils. However, buying him a packet of chocolate biscuits now and then always works well!!

[piglette in reply to Cobnut]

Dear Cobnut, the fatigue can actually get worse when you get down to around 7.5mg as that is when the adrenal glands have to wake up and start producing cortisol again after their long vacation. There is really nothing that can help the fatigue apart from rest and to not overdo things. I think I agree with your husband on the lentils!

[DorsetLady PMRGCAuk volunteer]

Hi Cobnut, think you're okay with blueberries, but as with all fruit there is a certain amount of sugar, albeit in a slightly different format. So don't indulge too much! But a little of what you fancy!

[PMRpro Ambassador]

Porridge plus yoghurt plus berries would have a fair bit of carbohydrate in it! I was just reading stuff for someone asking about carb content - and it commented that people think of dairy being protein, including milk.

If you really want to follow a low carb diet then fruit must be strictly limited - I have to stick to under 30g useable carb to be able to lose weight. I looked it up and found this:

Foods that contain 15 grams of carbs include:

A small piece of fruit

1 slice of bread

1/2 cup cooked oatmeal

1/3 cup cooked pasta or rice

4 to 6 crackers

1/2 cup black beans or other starchy vegetable

1/4 large baked potato

2/3 cup nonfat yogurt

2 small cookies

1/2 cup ice cream or sherbet

6 chicken nuggets

1/2 cup of casserole

1/4 serving of medium french fries

On the basis of this list - that porridge, fruit and yog possibly had at least 30g if not more - my total daily allowance to lose weight. And if the yoghurt was not full fat natural the carb content was probably even higher than I am allowing for.

I gave up trying to give my husband healthy food many years ago. I eat healthily - he gets his chips! He survived cancer 23 years ago - who am I to argue?

[Hidden]

There is a book from diabetes UK that presents carbs and cals of all different everyday foods including takeaway etc..it shows a picture and counts carbs in up to 3 portion sizes. If you want to be as low as 30g a day it helps you see what kind of general goods and portions size you can have. I have several books on resting and reseting the pancreas. Over complicated in some cases but if you want to go for it!

The diabetes miracle by diane kress is the one with really tight low carbs and is done in steps to rest and reboot insulin production.

Carbs and cals by cheyette and balolis is the one with pictures and is better if you are a visual learner.

[BonnyQuine in reply to Hidden]

I'm feeling v discouraged, last couple of days because, despite noticeably reducing Pred - now on 12mg ->> 11mg - my steroid-induced diabetes seems to be getting worse instead of better. My blood sugars are creeping up; not disastrous, but are hovering around 14mmol/l at all times - too high. This is despite a v low carb diet and maximum doses of Repaglinide + Alogliptin and Dapagliflozin. (Metformin worked better, but I had to stop it 2-3 months ago because of side effects.) Sigh. Will have to consult on what to do next . . . . Just having a moan . . .

[Hidden in reply to BonnyQuine]

Please 'moan' away. From June 2016 to Feb 2017 when I was put on insulin I was in high 20 and 30s even when I went down to 8mg of pred. Is that your own glucose meter or hba1c? The diabetes nurse told me to stop checking after steroids and eating as bound to go up and discourage me. I now only check pre breakfast and pre evening meal...srcond always higher. I have to check before driving according to uk laws.

It's that horrid feeling of no matter what you seem to do it keeps rising. If you are doing low carb and comb of meds you are doing your bit! I presume you had tummy probs on metformin. They have got me on trulicity/dulagatide injection once a week which was a big bit of jigsaw. Taking max of metformin, duglatide 1.5ml and humulin @26units twice a day. I was on glicazide for a while which was good for bringing it down. I think there are still drugs that might help but they all come with their own issues. I would be upping my fibre and fat content in terms of full fat yoghurt to slow release of glucose. Very fine balance. Like PMR high blood sugar comes with mood changes so bound to have up and down days. Hope your mojo comes back soon.

[BonnyQuine in reply to Hidden]

Thanks for your helpful response. Plenty to think about.

This is definitely a down day. Back soon!

[Hidden in reply to BonnyQuine]

Sometimes best not to think too much on bad days🤔

I was just wondering whether anyone knew of research that investigates whether people who do get steroid induced diabetes or like me go from controlled to uncontrolled Diabetes then go on to have lazy adrenal gland once steroids go down. Probably threads about it but Ha vent come across it.

[Patience_1]

I would also recommend the 8-day Blood Sugar Diet by Dr. Michael Moseley, and associated cookery books - very much linked to the Mediterranean type of diet. I find the meals appetising and easy to make - just what I need to make me stick to them!