Polymyalgia and Type II Diabetes

Hello everyone! I was diagnosed with PMR in November 2012 and until March 2014 was on 20mg Prednisolone reducing to 1mg. Since 2014 I have been clear of PMR. However, I am now experiencing pain in the shoulders and upper arms. I am having a blood test to determine whether this is the return of PMR. However, during the intervening years, I have been diagnosed with Type II Diabetes (which apparently can be triggered by taking Prednisolone I understand). My GP tells me that if PMR is diagnosed again, Prednisolone sends the blood sugars soaring. I am dreading this because at present I am able to keep my blood sugars stable and have been for a couple of years or more. Has anybody any experience of Prednisolone and Type II Diabetes? Thank you.

[DorsetLady PMRGCAuk volunteer]

Hi

Sorry to hear of your returning PMR - although if you were only treated for 2 years maybe it never fully went away - just lying dormant!

Your GP is partially correct, Pred can raise your blood sugars - but his comment about sending them soaring is a bit OTT - and certainly not helpful.

There are quite of few members who have both illnesses and I’m sure they’ll be along shortly to give advice.

[PMRpro Ambassador]

You can mitigate the effects of pred on the BS levels to some extent by changing your diet and cutting out processed carbs and added sugar (including some fruit). Exercise after meals also helps. There are people on the forum who manage just with diet, some need oral anti-diabetic medication and a very few require insulin. But I'll leave it to them to tell you their experiences.

I've been on pred for many years now - and my Hba1c level is still at 37. Absolutely no sign of pred-induced diabetes. But I am very consistent with what I eat.

[Hidden]

Hi pjsmum04, I was diagnosed with diabetes in either 2000 or 01. It was controlled by diet and Metformin then later i had to add gliclazide. In 2016 I was dx with PMR and in the first 6 to 8 weeks, I did let the appetite run awAy and put weight on. My pmr flared when I got to 8mg so back to 14mg pred. My blood sugar did rise and my hba1c shifted from 50s to 114 (not my highest that was pre dx fasting test) . I actually asked to go on insulin several times as I felt dreadful. When that hba1c came in I was referred to diabetes clinic which I started the low carb high fat diet favoured these days- because it works. I have been on insulin for 2 years now and in terms of management of diabetes it's great. The fact my driving licence is renewed is not so good but worth it (reminded me I may need to renew it!).

I probably sounds really bad but it's fine. My hba1c is down to 55 which is fine for insulin. The low carb high fat diet means that I am on about half the insulin I started on and I have lost 2stones in weight. I do hope to lose enough weight, albeit slowly, for diabetes to be diet controlled or reversed in the future. If you adopt a low carb high fat diet now you could be absolutely fine and keep your hba1c within acceptable measures. I wish had had access in 2001, but carbs were advocated as a good thing by my GP and practice nurse for years.

Even if I had known I would raise blood sugar and end up on insulin, I would have still taken pred. I was told when I was dx with diabetes that most people end up on insulin in 8yrs (am sure that was rubbish). It took 16 and pred so I can't complain. I look forward to when I no longer take insulin. But do the old low carb high fat diet and you stand a really good chance if staying diet controlled. I started with this diabetes uk site first...just in case you don't frequent. Here's the link.

diabetes.co.uk/index.html

[DorsetLady PMRGCAuk volunteer in reply to Hidden]

I didn’t know it was possible to come off insulin if you have Type2 diabetes- but is it very common - especially if you’ve been on it a long time? Does it depend on the level of dose you’ve been on?

I thought once you were on insulin that was it, but obviously wrong in my thinking. Although it’s not the same with Type 1 is it?

[Hidden in reply to DorsetLady]

Type 1 don't produce their own insulin so are on it for life. However, it was reported in diabetes uk news letter that they are testing low carb approach among other things to see if it can help insulin dependence. I have type 2 and I suppose technically steroid induced too. I have insulin resistance so I still produce some insulin but my body can't use it very well. Metformin reduces blood sugar and tries to whip up insulin. If my hba1c starts dropping into the late 30s and 40s I suspect I will be able to get off insulin. I have already started to have a couple of hypos which I hadn't had previously so think the reduction in weight is helping.

[DorsetLady PMRGCAuk volunteer in reply to Hidden]

Yes I’m sure it does. Let’s hope you can get off the insulin eventually.

Thanks for clarifying.

[Bramble01]

I was on pred for 2.5 years and became diabetes 2 which was easily controlled with Metformin and moderate diet control. Since coming off pred I am down to half dose with Met. insulin sounds extreme for diabetes 2.

[PMRpro Ambassador in reply to Bramble01]

medscape.com/viewarticle/87...

talks about using insulin early in T2 diabetes - and that it can reverse it. But if T2 gets too severe or cannot be well controlled with oral hypoglycaemics, insulin is needed.

[Hidden in reply to Bramble01]

I have had type 2 diabetes for almost 20yrs controlled by diet and Metformin and for 10yrs my hba1c was 6 in old measure. In june2016 my hba1c was 52, by November was 114 from steroid induced top up. My taper was extremely slow as my crp rose every time. My blood meter couldn't measure my bloods on a daily basis as it was too high and I was told after I should had gone to hospital. Insulin is not extreme at those levels, especially when I was low carbing. The amount of insulin my body was producing couldn't be accessed. It has left me with neuropathy because for months I asked for insulin and was told I would be off pred and it wasn't necessary. Extreme was leaving me suffering and gp ignoring me and Rheumy advice that I should be on insulin.

[PMRpro Ambassador in reply to Hidden]

I just don't get GPs who do that.

[Hidden in reply to PMRpro]

I did wonder if it was a funding thing. I also know my body is sensitive to infection and inflammation and that makes my daily numbers go up themselves. I didn't realise that at the highest numbers I should be on an IV of some kind. Potassium I think with other stuff. And I am supposed to have 20yrs of it! Only the fact I was ill and had no food probably dropped it a bit and helped.

[PMRpro Ambassador in reply to Hidden]

The neuropathy and other problems that may result from the uncontrolled BS will possibly cost them far more eventually. Like my daughter's problems that were dismissed by the GPs "It's not as if you are unwell is it?"

[Hidden in reply to PMRpro]

Comments like that are so comforting aren't they. Numpties.

[PMRpro Ambassador in reply to Hidden]

Except she was! She has to be dragged to the doctor ...

[Hidden in reply to PMRpro]

Bless. It's amazing for 10 years I never went to the drs either.