I've been diagnosed with Type2 Diabetes. My question is, will it go away when I come off Prednisolone? Has anyone experienced this?
I'm only on 3mg now, but assume the damage was done some time ago on the bigger doses. I've been on steroids for 4 years and from 15mg originally.
By the way, I've been on a very low carb diet for most of this year and had kept my carbs low for a couple of years. I cut back further because I had gained so much weight. I lost over a stone and despite the low carbs seem to be stuck again at the moment. In these circumstances the Diabetes diagnosis is very disappointing.
This might just help you:
Demystifying DIABETES
In relation to Polymyalgia Rheumatica & Giant Cell Arteritis
pmr-gca-northeast.org.uk/as...
The article starts on Page 4.
You can download the whole of the newsletter and keep it for reference if you so desire.
I would add that some patients who were present at that meeting and had both Type 1 and Type 2 learned more than they had previously been told and three of the Type 2 are now no longer Diabetic.
It also helped quite a few patients to lose weight, they did not have diabetes I should add.
Thank you so much! That was really helpful. I enjoyed reading the whole Newsletter. X
The other newsletters on that website, carry a information from PMRpro apart from other patients and medics and on some of the back page - jokes to make you smile.
To be honest. My portions are already very small and I don't eat the 'bad' carbs. Just the tiny amount in half a carrot or a couple of small tomatoes and a bit of sweet pepper. A couple of berries with my live home made yoghurt. No potatoes, rice, pasta, cereals. Nothing containing flour, so no bread, cakes, scones, biscuits or pizza!
I eat large salads of many greens, vegetables, fish, cheese like mozzarella, avocado and egg (I was following the low carb, mod fat and protein diet) I eat meat, but not lots. Stir fry cabbage with mince and curry spices is a favourite!
Satisfies me and I've got used to not having potatoes and bread.
Me too!
I've just read the newsletter, and see it is dated 2016. I have just received notification that I am a paid up member of PMR/GCA - will I get a newsletter local to me (south)? or is this north east newsletter a standalone publication in the one area? Sorry if answers to these are handy on line.......
I think it is NE members - but everyone is welcome to read the stuff on the NE support site - free gratis and for nothing without being a member.
PMR GCA UK (the national charity) issue newsletters.
The North East was a stand alone letter for the one area. We put them on our website following distribution of hard copies had been circulated.
Very useful. I'm not diabetic or pre-diabetic but using Dr Michael Mosley's Blood sugar diet to lose the weight I put on whilst on steroids for 5 years. It's slower than for most people, presumably because steroid weight is hardest to lose. Still have a big slab of belly fat that's hard to shift.
It can be reversed. I can recommend Dr Michael Mosely ‘s book The 8-week blood sugar diet. I am depressingly near this diagnosis too and not really facing it.
This really works! I’m no longer diabetic. It was steroid induced.
It depends - is it really steroid-induced diabetes or Type 2 catching up?
Are you on as low carb as you think? Fruit counts for example. How did they decide it was steroid-induced and what is your Hba1c level?
Very low carb. Was attempting Keto for a while. I don't really eat fruit now. I have a few berries i.e. One strawberry and 3 blueberries with my home made yoghurt in the morning before Pred (and now Metformin!)
They are assuming Steroid induced. There's no family history of Diabetes. However, I am overweight, hence the low carb diet. I'm about 2 stone overweight. If I lost that, I'd be back to pre PMR and steroid weight. They did do Hba1c test, it was 49.
If you have diabetes, an Hba1c of 48 is taken as an ideal aim. That's with metformin - so you'd think being at 49 without it and being on steroids might be acceptable????
Wow! I just knew you'd have the sensible answer! She did say that if she had a patient who had come down to 49, she'd give them a gold star! But because I am on steroids she wants it to be lower.
I'm taking the Metformin and don't seem to have side effects but I've stopped the statin because I had terrible pain in my back muscles. She's going to be cross with me but my Cholesterol was normal,never been raised, and I'd like to keep tabs on it and my blood sugar with blood tests and try to control both with diet and exercise.
If you aren't having problems with metformin fair enough (maybe) but really - the Hba1c reflects ALL the raised sugar levels so they are obviously not too bad. I imagine you realise I wouldn't...
Haha... Yes, I figured that. The Fact that you wouldn't be worried helps me a lot. I will review my decision after my next blood test.
Re the Statin! I've read about your experience with statins and didn't think I needed them but she frightened me into taking them. I took them a week after I started the Metformin so that I could be clear which side effects were which! Anyway, I will have to find a brave day and go and see her and try to negotiate my way forward. I've got Labyrinthitis at the moment so that puts it off for a wee while yet!
As ever, thank you for your knowledge based common sense!
Hi Sheilamac, I don’t know how old you are but there has been some research which says that for women over 65 statins do not help unless of course you have had heart problems.
Thank you for reminding me ! I did see that. More fuel for me when I see the Diabetes Nurse, because I'm 73 (can't actually believe I'm saying that...) 😉
And no previous heart problems and not even any in the family!
I do have higher blood pressure than she would like 'because I have Diabetes', otherwise it'd be considered in normal range. I refused the medication suggesting that it'll come down when I lose this weight. She's given me 2 months...
They keep saying that, and I fought about it for ages with my doctor, but my cholestrol went up to 348 (or there abouts - can’t remember exactly)! Anyway I took the statins and within a couple of months my cholesterol was down to 162 so I have kept taking the statins, at least I will till I get my next results. I’m 79 and have high blood pressure.
Hi Sheilamac. Another misled doctor. I cannot believe you have been given statins - especially when you say your cholesterol is normal and there is no history of heart problems. Please don't take them before you have listened to the following it's long, but stick with it - you will be appalled! This will give you the courage to refuse the medications you appear quite rightly to be worried about
youtube.com/watch?v=jcnd3us...
and
youtube.com/watch?v=fzZVJDz...
Someone else has recommended Moseley 5:2. Good.
Also look at Dr Jason Fung's books...The Obesity Code and The Diabetes Code.
Jason Fung is a Canadian Nephrologist (kidneys)
Aseem Malhotra is a British Cardiologist from Cheshire.
Good Luck with everything.
I think one reason may be is that doctors get funding on the number of people for whom they prescribe steroids. It was around 7 million people in U.K. it may be even more by now.
And read The Great Cholesterol myth, there is no link to heart disease unless the cholesterol combines with eating too much sugar. GPs get a bonus for putting people on statins.
I am reading A Statin Nation by Dr Kendrick at the moment. A real eye opener.
I am type 2 diabetic. I was diagnosed about 4 months after being on prednisolone so think I may have had it unknown for a while especially as I was in bed for about 3 months pre diagnosis and being given the wrong type of food to eat to cheer me up. On diagnosis I changed to a LCHF diet.
After about 6 months and on gliclazide I bought my hba1c down to 39 and was taken off Meds for a month top see how things went. My next hba1c was 41 and my most recent one was 40. I am now in remission. I am on 6.5 mg of prednisolone and know my blood sugars go up in the afternoon due to the steroids. Good luck on your journey.
Yes me too. I have been off them for 2 wks, after 3yrs, starting at 15mg. My last blood sugar test was still raised & so have to see my Dr on Friday re this.
This was really helpful. The article explained the link between PMR and diabetes clearly.
I was diagnosed as borderline diabetic as a result of recent blood tests relating to CHD. My diet is good, so it’s likely to be steroid related (I started a year ago).
Thanks for sharing this.
Pym
Hi
I had a pre diabetic diagnosis twice during my 3 year Pred journey and each time was " rescued" by severe dieting. Not just low / no carbs but calorie control, using an on line calorie counter with item and weights etc for EVERYTHING. You need to be well below 1000 calories per day.........looks like nothing much. But body gets used to it after 2 or 3 days and hunger disappears. It took me 8 strict weeks each time at 800 calories. Maintaining is obviously a problem for me, but then I've had a year of immobility due to severe osteoarthritis and 2 hip replacements. Weight loss will be my next attack when I recover, then PMR. At present on 2.5 mg Pred per day.
Sorry, this all seems a bit harsh but surely better than Diabetes type 2 medication.....plus the eye, amputation and such. Just saying.
Valerie
One hundred calories a day????? Are you sure!
800 cals per day is the basis of the Newcastle/Glasgow diet approach - seems to work really well.
I had already edited the 100 to 1000.....you were quick off the mark, well spotted. I always retread my posts these days......hate predicted text etc.
Just hope I wasn't too harsh. Valerie
Why? Any dietary approach is better than stuffing diabetic meds. I have a friend whose GP (supposedly the practice diabetes guru) told her he didn't expect her to be able to reduce her Hba1c significantly (it was over 60), that it was calories that mattered not carbs and just to take more metformin! As she sat down on Saturday morning to 2 rolls, butter and jam as her "treat"...
What happened in the end with your friend? Did she give up the rolls and jam or stick with the Metformin?
I don't know what to think now... From what I've read, the Metformin makes a difference pretty quickly, so it'll be interesting to see the results of my next blood test.
No idea - that was just in the spring, haven't seen her since as she is in the north of England and I'm in Italy! It's one of those friendships where you sit down together when you can and catch up the last 2 years as if they didn't exist..
I just don't get the point of telling people to eat carbs (which are what cause the problem) and use medication to make up for it.
I think a while back carbs were considered the right thing to eat for diabetes, since then they discovered they were wrong, perhaps not all doctors read about it! Only the ones who can read.
Maybe not too many then? But what I don;' get is that physiology and biochemistry teach you it can't be right...
In a lot of cases they don’t even need physiology and biochemistry they just need common sense. eg dropping people to zero on pred when they are in pain will not get rid of the pain.
Absolutely PMRpro - most of what the medical establishment dishes out a propos diabetes makes absolutely no sense at all. To quote Jason Fung - it is impossible to treat a lifestyle problem with drugs - the lifestyle needs to change. In T2diabetes and obesity too much insulin is the cause not the "cure" and it makes no sense to pour in more insulin and carbohydrates. It could be likened to trying to put a fire out by spraying petrol on it. Nuts!
I had to sit with a diabetes nurse telling me I would have to eat carbohydrate with every meal in order to balance everything. What she was saying made absolutely no sense at all - she must have misread the consternation on my face (!) as she then suggested I go to a talk about diabetic nuitrition and attend a local support group.
"What does the support group do?" I asked.
"We get together once a fortnight and enjoy tea and biscuits" she replied.
"Urmm, no thanks!"
I went away, picked up the bits of my sudden decline into the world of PMR and diabetes and sorted myself out with some research. Result? Normal BS, significant weight loss (about 6 stone) despite still being on 3mg pred.
Is it a coincidence that not only is BS an abbreviation for blood sugar but also for bull shit? (Apologies to those who are offended by the language).
Tea with sugar no doubt. You couldn't make it up could you? OH got a good laugh out of it too.
So how did you lose 6 stone sennatta?
A mixture of stuff. Did a lot of searching and acted first on the ruminations of Dr Sarah Myhill (excellent website and books) and the writings of Dr Jason Fung who has three books published at the moment - The Obesity Code, The Diabetes Code and one about fasting. So I have followed his writings in those ...and hey presto, bim bam boom.... success!. So basically fasting for varied lengths of time and a paleo ketogenic diet when not fasting. And no - I don't feel hungry and tired when fasting, which happens after I eat carbohydrates and the latter also after over eating. (Think about how everyone feels after, say Christmas Dinner!) I also do some resistence exercise and walking , but that's for other health reasons and will not impact much on weight loss.
Oh and by the way, I am not sitting around the house for most of the time - I teach music five days a week and do bed and breakfast some of the time in addition to managing the household ,my pmr and learning to play a new instrument!
Metformin worked quickly and v well for me, but gave me terrible gastritis, so I had to stop it. Since then I take Repaglinide (dose varies - short acting), alogliptin (one a day) and dapagliflozin (one a day), and these have been effective enough and have caused v few problems.
Been on pred since Nov 2016. Diabetes within days. Was pre-diabetic beforehand, so guess pred (40mg start) tipped me over the edge.
Am also on a v low-carb diet and my HbAic is now normal (39 - 41). Diet = low carb, med fat + protein and max veg. No calorie counting - life's too short! Am staying on diabetic meds in the meantime, as have been v inactive for various reasons, and want to achieve some degree of activity before stopping those. (Diabetes has consequences, which I'm determined to avoid if poss.) I do use a blood sugar meter to monitor. BS still up in the morning, after night-before pred. Do hope to get off diabetic meds once I can get off pred. (Long and winding road!)
Pred = 9mg at present. (Went back up to 10mg after a recent flare.)
Re blood pressure, you can probably find a tolerable med for that. I originally had Lercanidipine, which I could not tolerate at all and had to stop. Since GCA + pred have had Candesartan, which has been quite effective and has caused no problems. Tried stopping it recently but after a short while, the blood pressure shot back up to scary levels. (That's at home using own sphyg. Clinic ones are often quite inaccurate. Must have a good one.) Started Candesartan again and am now ok. Fingers crossed.
Managed to avoid statins. 
Best of luck.
Thank you! Very helpful. Great to get your experience and insights.
I've to hand in a few weeks of my own BP results so she can average them. Just looking at them I think they will come out at about 142\78. If I get tested in the surgery its scarily high! I'm confident that it will come down as I lose weight. Same diet as you. Am a bit stuck at the moment, despite eating very little while I've had Labyrinthitis and now I think I'm post viral. It seems very unfair to me! Hopefully when I get moving again, it'll start to come down.
Are you in Aberdeenshire?
Good Luck with the rest of your journey!
Heart in Aberdeen, but body in Greater Manchester. Life!
Commiserations re labyrinthitis - had it a few years ago = no fun. W any luck the effects will soon pass.
Agree when tested in surgery, BS is always scarily high. Much calmer at home! 142/78 sounds wonderful to me, so hopefully you'll be fine. My recent scary readings were ~ 244/125 or so = oh dear! Have got them down to nearer yours now.
Good luck w getting moving. No use getting stressed about it - we just need to do what we can when we can, and change position (stand up!) at least 3 times an hour (give or take).
Onwards n upwards
Oh my Goodness that was a high BP! Stroke level, terrifying! I can reach a systolic of 200 in the surgery! at home I've been as high as 170\96 but it seems to be settling. I know that I was stressing myself about the diabetes, what I should be eating and dealing with the docs, I am distancing myself from them more now.
We used to have a small hotel \ Restaurant in Strichen and we had a lot of Quines there... some bonny and some not so.... hahaha
Koalajane seems to have got her blood sugar right down using LCHF diet. For me that's an easy, interesting diet to follow. I'm going to weigh my food and check the calories. I'm sure it can't be more 1000 cals because my portions are small.
I've just reread her post and she was on a diabetic drug as well, but got down to normal and off it in 6months.
Hi Sheilamac - Strongly recommend you research getting out of the calories mindset. It was cobbled together and not based on anything scientific, but well marketed. It only works short term and messes up the metabolism. Good luck
I don't have a calorie mind set. Counting calories is not my way, however as I can't seem to get my weight down past a certain point on my LCHF diet (up to now I've lost 1 and a half stone). Was thinking that maybe there were too many calories in it at the moment
Hi again Sheilamac. I hope I didn't sound critical - I didn't mean to. I think most of the population has a "calories" mind set owing to indoctrination over the past few decades. My thinking has radically altered over the last 18 months or so and it is clear to me that the what and when of eating is far more important. For example, it is far better to eat, if one is talking calories, 100's derived from natural fat which will not impact on blood glucose triggering an insulin reponse, than fewer derived from carbohydrates. The refined carbohydrates are rapidly transformed into glucose, which in excess is pushed into the cells to be stored as fat ( which is a "safer" bet than storing glucose in the body) by the insulin. It is also better to leave long periods of time between eating rather than grazing which is often encouraged nowadays, because constant eating means there will be a constant flow of insulin sloshing around tidying up he glucose and storing it as fat, which is not what we want. Giving the body a rest from eating (ie fasting - which is simply what we do when we sleep, and during the hours between meals) means that we can draw down the stored fat for nourishment in stead of living on what we've just ingested. So in this way, we can lose the excess weight.
A reasonable analogy would be going to the feezer to find some food rather than going to the shops and buying some more.
I am not a scientist or medic, but a humble musician, so I recommend that others should go and seek the information - it's out there, makes eminent sense and it works. The problem is that the medical establishment, the pharmaceutical companies, the food producers and politicians are so financially intertwined that they cannot easily extricate themselves. There is no money to be made from telling people to eat proper food, differently, eat less and less often and much face to be lost in doing an about turn! Just saying :o)
Spot on.
And most medics were trained before these facts became apparent, and before nutrition was thought to matter much, and haven't caught up w them yet.
Medics are given no training in nuitrition apart from a passing reference to rickets and scurvy!
What, still? Oh dear!
It is getting worse, not better!
I checked my calories for a day and they were 780 !
In which case - you may need to eat MORE. Too little food induces a state of starvation in the body. That is the point of the low carb approach - you can eat plenty of calories and STILL lose weight.
I know, I was actually recovering from a virus at the time of the calorie count, but thought it wasn't much different and somebody was talking about doing 800 calories. I like the low carb diet but I've got very stuck with no weight loss for a few months and I'm frustrated. I tried eating a bit more 'normally' but I gained immediately! I really thought that by the time I reached 3 mg that the Prednisolone wouldn't be still making weight loss a problem. Indeed I loved reading about people whose weight 'melted away' when they reached 7-5mg. Oh, I wish!...
Do you mean the 800 calorie approach they use for the Newcastle diabetes study? That is just for 8 weeks I think. But I think everyone gets to a point where weight loss becomes hard - I did at about 71-72 kg, I stuck there with no real problem until the rheumy persuaded me to try methotrexate - and in the month I was on it I gained well over 1kg, That doesn't usually happen as most people feel sick - I didn't and the mtx seemed to potentiate the pred side effects - including ones I'd never had!!! And it isn't going away...
I had type 2 diabetes pre-Pred/PMR and reversed it with diet and exercise.
It came back with the Pred and I've reversed it again through diet and exercise - LCHF mainly (although I've been on the Auto-Immune Protocol since March which has been a massive help!) plus resistance/strengthening exercise and gentle walking.
I put on a lot of weight when I was first on Pred and have lost nearly 3 stones since then. This has been gradual and controlled...and very satisfying. I'm losing about 1/2 lb a week now...with the occasional momentary upward blip!
I'm currently on 7mg Pred and below borderline Type 2.
I still have some weight to lose but I'm not in any hurry and I know it will come off as I reduce my dose - all in good time!
Another important part of the weight loss for me has been making sure I get enough quality sleep. This is a little-known factor but it is very significant, as is good stress-management.
I give a lot of attention to both of these and they really do make a big difference. Definitely worth looking at...
Steroid-induced diabetes
PMR + type 2 diabetes 
GCA and type 2 diabetes
