Type 2 diabetes

[bumpermac]

Tapered off pred 18 months ago after nearly 3 years . Was diagnosed yesterday with steroid induced type 2 diabetes. Needless to say Im in shock ! Anyone else diagnosed ??

[SheffieldJane]

Sorry bumpermac, it is one of the possible bad side effects of long term steroid treatment. Like you, I would have thought I was out of the woods after 18 months of being steroid free. I was under the impression that it was caused by a change in the way sugars are metabolised whilst taking steroids. I will need to read up on it all. My blood sugars show that I am close to being on the high side and have been told to address lifestyle issues, the usual diet, weight, exercise . I have also been under the impression that this can be addressed and reversed by d, w, e. Perhaps I am in a fools paradise.? I did however know that it was a danger . I have been having steroid treatment for 3 years 9 months for PMR. Currently on 4 mgs.

A number of members have this diagnosis. I think Poopadoop is one.

[PMRpro Ambassador]

Under the circumstances I think I would be in shock! Someone may have got their concepts crossed!

The point of steroid-induced diabetes is that it is diabetes that occurs while you are taking pred and improves once you stop the pred. It is caused by the pred triggering your liver to release spikes of glucose into the blood - which can be high and they contribute to a much higher Hba1c and also high blood sugar levels at times.

If you have been off pred for 18 months I think it is unlikely you can blame pred - it's plain old-fashioned Type 2 I fear. And yes - it is possibe to reverse Type 2 diabetes by addressing lifestyle and dietary choices.

One interesting study in Newcastle and Glasgow has found it can be done quite quickly:

ncl.ac.uk/magres/research/d...

As it says in the link, they provide the info because it isn't going to get in the textbooks any time soon - but the low carb approach and the diet are beginning to reach the diabetic clinics.

[Bird-67 in reply to PMRpro]

Hi PMRpro, I was diagnosed with type 2 Diabetes about 6 weeks ago and the last two blood tests have shown a high increase in my liver function. After reading this post just wondered if there was a connection?

You lovely informative people on here seem to know more than the so called experts.

Bird x

[PMRpro Ambassador in reply to Bird-67]

Not that I know of - but I;m not a diabetologist. But it should be investigated. What other medications are you on?

[Bird-67 in reply to PMRpro]

Thanks for your reply PMRpro,

I have checked all my medication and the only one that says it can affect the liver is my Statins so have stopped them until I see my Consultant again.

[Hidden]

Hi bumper mac, it must have been a bit of a shock after being of steroids for a while. I was dx with type 2 diabetes in 2001, which wS controlled by diet, metformin and a weekly injection called byetta as the years rolled on. My hba1c jumped from around 48 to 114 the first year on pred and eventually I went on insulin.

I wondered if the joys of a low carb diet was recommended when you were on pred. It helps control the blood sugar spikes caused by pred. Basically if you eat sugar, white bread, pastry, white pasta or any other processed food whilst on pred your blood sugar would have been climbing by the sound of it. You are now resistant to the insulin your body produces so your body can't use the insulin that is released to deal with the glucose processes. A low carb diet is the first step to getting your blood sugar down by eating foods that don't turn into glucose quite so much or for so long. I will add a couple of links to get you started but there is every possibility that you an reverse it with minimal meds depending on your current hba1c. Get over the shock, read the links and ask any questions you need to.

What is your hba1c now? Ask if you can be referred to a good nutritionist.. (If they don't advise low carb, ignore them) ...and the diabetes clinic. I hope to get off insulin eventually then will be a case of trying to reverse it. I have lost well over 2 stones and I eat about 60g carbs a day 80 to 90% of the time.

ditchthecarbs.com/guide-to-...

dietdoctor.com/low-carb

You may want to have a look at this website too.... I find it helpful. And I agree it is probably "just" type2, but probably started the ball rolling with pred.

diabetes.co.uk/

[bumpermac in reply to Hidden]

Many thanks for info . Myhba1c is 48 so it is just in danger zone . Read all info about low carb diet and started following it . Had meeting with diabetes nurse this morning and she raised her eyes at me .... said only way you can manage diabetes is on low fat and high fiber !! Wouldn’t even discuss anything else ! I’m going to try Michael mosleys blood sugar diet which seems pretty intense but he reversed his own diabetes so will keep you informed !

[Hidden in reply to bumpermac]

Any low carb high fat diet will help. I was told to eat pasta and carbs but no jam???

[PMRpro Ambassador in reply to Hidden]

Can anyone explain to me why they think it isn't a good idea to remove the substances that actually cause the problem? i.e. carbohydrates ...

[Hidden in reply to PMRpro]

No idea. Now I think what a chump. But even in 2001 the knowledge base wasn't anywhere near where it is now.

[PMRpro Ambassador in reply to Hidden]

20 years ago sure - but we are nearly in 2020 and the low carb bit has been around for a while! Nurses I may be able to excuse - doctors did biochem and physiology, they should know better,

[Hidden in reply to PMRpro]

I don't know why the penny didn't drop for me sooner though. I knew that historically type1 had been "treated" by pure protein diet. I suppose I thought vegetarian... That's no good... Meat and fish. It wouldn't be easy without the high fat part for me. I am struggling at the moment as dairy and eggs are an issue. But roasted med veg with halloumi or a veg stir fry keep me up and at 'em.

[Travs in reply to PMRpro]

yes I watched a TED talks lecture today, the problem is fats and lipids within the cells are blocking insulin so glucose cannot be taken up by the cell. conventional medicine dictates lowering carb intake but the new thinking is to unblock the insulin receptors with a low fat diet thereby reducing the insulin resistance see here

ted.com/talks/peter_attia_i...

[PMRpro Ambassador in reply to Travs]

That isn't very new thinking - that dates from 2013 if you look closely. Newcastle and Glasgow have done some good work in the last few years about very low calorie diet for a short period. But there is increasing evidence and support for low carb in Type 2 diabetes.

[PMRpro Ambassador in reply to bumpermac]

Oh dear! That is what my friend was told by her GP who told her it was all about calories! She struggled at first - until the low carb message was introduced and since then she has lost 2st in weight and her Hba1c is now down to 51. Personally I think she is underestimating her carb intake, there was a massive pile of sweet potato and other carby veg on her plate! Healthy - but not low carb,

[Hidden in reply to PMRpro]

The clue is in the name there though... Sweet potato... Double whammy but at least has more vits than potatoes.

[DorsetLady PMRGCAuk volunteer]

Would guess that it’s not totally steroid induced... maybe not to blame on this one.

My sugars did go up slightly when on high doses of Pred, but were back within the normal range as I reduced... and have been ever since.

But, whatever caused it, it’s a bit of a downer!

[tangocharlie]

There's a lot of evidence that low carb diet can reverse T2D. read the Blood sugar diet by Dr Michael Mosley or anything on the ketogenic (keto) diet, they explain the mechanics of how T2D happens and how you can reverse it. His book mentions the Newcastle studies a lot.

[bumpermac in reply to tangocharlie]

Just finished his book and intend to try diet

[tangocharlie in reply to bumpermac]

Worked well for me, though I'd do it in January, it'll be too hard trying to start now with all the temptations of the season! I'm trying to follow keto now but keep lapsing. Weight loss is very slow compared to others but ignore the scales and go by clothes sizes. Having support really helps - if you're on Facebook there are some excellent support groups that work like this forum. I think there is also one via the diabetes.co.uk website which has lots of good advice on low carb eating. Since quitting sugar and bread I've felt so much better, and feel the difference instantly when I occasionally yield to temptations. Initially all my inflammation readings halved too. I'm not T2D but was hovering close to the pre-diabetic range. My Hba1c is back down at 39-41 now so I'm on the right track. Go for it, it becomes a way of eating/way of life and you'll never want to go back to eating carbs and junk.

[Koalajane]

Hi, I was diagnosed type 2 about 3 months after PMR diagnosis. I went straight on low carb high fat diet and was put on gliclazide. 6 months after my hba1c went to 39 so my diabetic nurse took me off the gliclazide. I have stayed in remission for the last 2 years and my last hba1c was 35. So yes the LCHF way of life can put your diabetes into remission. Good luck

[Hidden]

This is a longstanding chat about what people eaten on their low carb way of eating on diabetes uk. It goes back 4 years but it's good to see the different things people eat. I don't eat meat but some of the veggie stuff looks good. I had to smile at the poor person who hadn't yet been dx with diabetes... Read and you will see. Its a good link to have when you don't know what you fancy.

diabetes.co.uk/forum/thread...

[Jane-s]

It’s a pain isn’t it,! About 6 months ago my blood sugar was suddenly 45; I started the pre diabetic course which has been quite good, particularly the first 4 weeks.

If I ever get off steroids( 20 mgms) will the diabetes fade away?

Soldier on!

Jane-s

[Hidden]

Me. It’s really odd being type 2 one minute then a week later being told I am not diabetic.

[Pixix]

I was diagnosed with prediabetes one week after I was diagnosed with PMR...not something I’d wish on my worst enemy! My doctor apologised! Went straight onto low carb keto diet...found a lot of recipes on Pinterest, & useful info on other sites. I haven’t had another blood test yet as it’s onky been a few weeks. I lost a stone in three weeks, but then 5lbs went back on. Not a single cheat, either. I believe that being on steroids is sufficient to raise your weight somehow...would be interested in others views on that. I piled on 2 stones during steroid intake for chest infections 4 years ago. I tried hard, but no diet worked well. I’m stopping keto on Saturday to do 5:2 during Christmas, then back to keto. If you cheat on the keto diet it just turns your daily diet into a hugely fattening diet...it only works if you eat virtually no carbs, I think.

[Travs]

Yes me too Got my PMR diagnosis 4 weeks ago and it's been a rollercoaster, 2 weeks later diagnosed with GCA and Pred went to 60mg which tipped the balance so I now also have type 2 and Metformin. Had to come home from work at the very worst time of year but I'm hoping to be back in for Christmas. I'm now trying to adjust my food cupboard so have come here for guidance, I'm just about to ask for help now.

It's a bit of a blow isn't it ?

Hope you are on the mend soon though bumper.