I have been on Prednisolone for about two and a half years for pmr. I started on 15 mg . Have had a few ups and downs but am now slowly reducing successfully it seems. Down to 4 mg at present.
Shocked to receive a letter from GP referring me to a life style course as blood sugar level is 43 Mmol. I hadn’t realised that steroids could interfere with insulin levels to such an extent. Is there any point in going on a lifestyle course when on steroids? I am 82 , put on about 6 lbs . I am not on any other medication .I am also Coeliac .
Thank you for any advice .
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Susieblu
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It isn't insulin that pred interferes with - pred changes the way we metabolise carbs and also triggers the release of random spikes of glucose by the liver. The latter alone are enough to raise your Hba1c - which is a reflection of your average BS levels over the past 3 months.
I think your doctor is over-reacting: a level of 48 for the Hba1c is usually regarded as the cut-off point for diabetes and 42-47 is the range for pre-diabetes so you are barely into that range! This explains it all quite well I think.
Reducing the amount of white carbs (white flour baked products, pasta, rice and potatoes) is probably more than enough for you to get that Hba1c level back to 41 where it won't trigger a knee jerk reaction by the computer! I realise that you won't be eating the usual baked stuff - but gluten-free substitutes are very carb-dense with easily absorbed white carbs and have quite a bit of sugar to make them taste "better" and more like the "real" thing. As a coeliac I imagine you eat a lot of fruit? I did when I was eating a normal gluten-free diet (I have a wheat allergy) and there is a fair amount of carbs in fruit - contributing to the total carb intake and your BS levels.
We do talk a lot on the forum about a low carb way of eating when on pred - not only because it helps avoid the weight gain most people experience when on pred but also because it reduces the risk of developing pred-induced diabetes.
Whether the life-style course would bring a lot of benefit for you I'm not sure - they will probably tell you all about dietary measures and encourage you to lose weight and take regular physical activity. I don't know how limiting your PMR is and I've just told you that. Don't know if the course will add much to it!
Of course there is a point Susieblu - to feel as well as you can. They must have a promotion on because I got the same letter. The surgery nurse can’t see me until mid July, so in the meantime I am cutting out all sugars and white carbs, processed foods and alcohol. I am also making the effort to be more mobile and perhaps lose the weight that’s crept on. Hopefully I may have righted it and the raised cholesterol by the time I see her. I am having one of those glucose tests, where you bring your own Lucazade and you wait around to see how it’s processed.
I have had the preliminary interview and am now going on the NHS Diabetes prevention plan. I got the interviewer to test my blood again today. Down to 36mmol! I think it was all the birthday cake I ate that put it up previously but it is a fair warning to me .
I shall continue with the DSNS reduction in Pred and hope it all settles down.
My partner needs to go on the course as well so will keep him company.
I am very grateful for all the time taken to answer our queries.
I did that when I was pregnant once. I ate a box of Jaffa Cakes went for a blood test and was kept in the hospital having my thumb pricked every 15 minutes. I have never eaten a whole packet of biscuits since. 😆
To you and Susieblu...it can be done....just got back from hospital, my reading for prediabetes in February was 44.....now it is 38...they were quite amazed how much in so little time I had cut it down, no moreso than me...….90% sugar....75% white carbs did it for me....lost nearly a stone in weight.....if I can do it....you can...will add the odd slice of bread now.....aren`t I daring!....but that is what I have missed at lunch time with eggs etc....
Did not go on the lifetime course, wanted to do it myself.....
A friend of mine has just been diagnosed as prediabetic at 43 mmol. She went on a course and thoroughly enjoyed it and learnt a lot from it. It seems they are encouraging all people who drop into the prediabetic group to go on courses now.
Snap!!!! Before I was hit with GCA and PMR I received a letter out of the blue saying I was at risk of developing diabetes and I had been referred to the company that run these lifestyle courses. I weighed 10 stone and was very active and fairly fit but had been eating a lot of cakes prior to the HbA1c test! This news stressed me sooo much and I immediately changed my diet. Then I became ill with this pesky illness! Whilst at GP being diagnosed I asked about this pre diabetes diagnosis. My blood sugar was 41mmol. I asked why I had been referred and was told it was automatic due to government guidelines. I went to the first course meeting. It was run by an educationalist who had no healthcare qualification. I said I didn't want to be there and explained nicely that I probably knew more about diabetes than he did because of my career (though now retired). He suggested I continue because if I didn't attend the GP would be informed and perhaps it might affect my future relationship with the practice! I decided to pull in my horns and be a good girl and comply. I never heard anything more about follow up dates? The truth is that GP practices receive funding for every patient they diagnose with diabetes, asthma,COPD and hypertension. The bar for diabetes has been lowered with pre diabetic blood sugar levels being reduced to the levels quoted by PMRpro only fairly recently. Thus more patients end up in the fishing net.
Yes, you are absolutely right....the lady that sat with me at the hospital was in your position too.....not even pre diabetic but they wanted her to go to a group, but like me refused......they told her GP's were being paid to refer us.......I do think and know some people that are quite unaware about food and what it can do.......but there is so much out there to find out, without going to a group....
How helpful the course will be depends on how up to date the leaders are. if they are of the establishment then they will be pedling myths. As in a previous post, I reccommend you look out for Jason Fung and Sarah Myhill. The former has written three excellent books including the Diabetes Code which will help you to sort out your blood sugar wobble and also have a look at Myhill's "Sustainable Medicine"
Hello Susieblu. I was told at Xmas that I was pre-diabetic with a reading of 42 and I am now half way through the diabetes prevention course. I thought I knew a lot about nutrition but have learnt so much from the course, no more low fat anything, no processed food, low carbs all the way. Having followed their guidelines, I m no longer pre-diabetic. Sugar levels now down to 37 and in the process I have lost 1.5 stone. You have nothing to lose by going on the course, only gain. I feel we have enough to deal with having PMR (and other various ailments), we really don't want to add diabetes to our list.
I’ve read this thread with interest as my blood test last month was fine for ESR and CRP and I scrolled down feeling chuffed (results were on line) and then saw the HbA1c was 44, which was a shock. Pre-diabetic. The practice called me in for a meeting with the practice nurse. I expected to possibly be patronised about my weight, but it was really helpful. No mention of any commercial course.
My weight had shot up post Pred (reduced over time from initial 30 to current 4.5) and I’d not done at all well on cutting carbs, so this was definitely the kick I needed. I bought Michael Mosely’s Blood Sugar Diet Book, and with a few wobbles have lost half a stone so far. I hope to keep going till another stone’s gone, then move to 5:2 to try and not slip back.
Regular GP appt next week, and hopefully a few fewer pounds by then. Let’s just hope her giant step on scales agree with my bathroom ones!
Susie, you aren’t pre-diabetic at present so have a real chance that with a few changes you never will be. The evidence is pretty clear that the damage can be reversed, particularly in the early stages. Good luck x
I was told that the Living Well programme is run by the NHS . Because I am Coeliac I am well used to checking the labels in supermarkets and now I have learnt that 1 teaspoon of sugar equals 4 gms I can check that as well!
The initial prog. is one & half hours a week for seven weeks.
I hope your weigh-in will go to plan as you have done well so far.
Sometimes I think it is a job to know what to eat what with sugar and cholesterol and in my case gluten .
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What's been your blood sugar experience?
Just diagnosed and anxious 
CRP levels raised
Blood sugar
Blood tests 
