4 weeks ago I was diagnosed with PMR and put on 20mg Prednisolone. 3 weeks later while trying to taper I was Dx with GCA and the Pred went up to 60mg.1 week later I was sent home from work and diagnosed with type 2 diabetes ( type 2 NIDDM from now on)
It's all been rather a lot to take on in just 1 month all with a backdrop to feeling guilty about not being able to work at our busiest time. As a Paramedic of 38 years I know quite a bit about NIDDM but I have never shopped as a diabetic before so find myself in need of diet advice and how to stock my fridge and cupboards.
So if anyone could share their strategy I would be very grateful
Thank you
I'm still waiting for an invite to Rheumatology, my GP sent them an email a week ago so I have only had 1 GP appointment of 10 minutes since this all started. This means Im on 60mg UFN for now. I'm so glad this forum exists or I really would be all alone with this struggle. so thank you all
Yes its an old photo but why keep them if not to use lol
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Sorry to hear your news - must be devastating for you - thinking you only had PMR to contend with, but now finding GCA and Type 2 diabetes added to the mix.
My late hubby was diabetic, and the diabetes nurse used to say - just eat a healthy diet, no need for special ‘diabetes’ labelled foods. Just stick to good ingredients cooking from scratch preferably and avoiding sugary starchy processed foods - much the same as the advice we give for PMR and GCA really.
As for 60mg for GCA you will probably be hyper initially until your system gets used to all that excess cortisol charging around - bit like a toddler overdosed on chocolate and fizzy drinks! I’m sure you’ll recognise the symptoms!
You may also find that sleep is a problem - I found I got sleep easily enough, but come 2,3 or 4 am I was wide awake and ready to run a marathon!
You’ll need to be on 60mg for at least 2 weeks, 4 is better - to ensure your sight is protected, and the inflammation caused b the illness is mopped up sufficiently. The first 6 months are the most critical in GCA, so don’t let the doctors try and reduce you too quickly - they will try, especially if you are diabetic as Pred can take its toll on that.
Just for info this was my reduction plan from 80mg (already lost sight in one eye) to 15mg - not saying it's what you should do, but gives you an idea -
80mg - 2 weeks
60mg - 8 weeks
55mg - 2 weeks
50mg - 3 weeks
40mg - 2 weeks
30mg - 3 weeks
25mg - 4 weeks
20mg - 5 weeks
17.5mg - 4 weeks
15mg - 6 weeks (Xmas period)
Just come back at any time as queries arise, and good luck
Its an abbreviation I use at work only because its quicker than writing it in full and a convention amongst medics to distinguish between insulin users and died med users so Im self appointed lol
I know what NIDDM is - I worked in the medical field most of my life But steroid-induced diabetes isn't quite the same - for one thing, random BS checks can be misleading (pred triggers the liver to release random spikes of glucose, not related to food) and it WILL improve as the steroid dose reduces. Bee has given you lots of advice - and we have members on the forum who have brought their Hba1c back to normal just by diet.
Have they provided you with a free blood sugar testing kit and plenty of strips?
If not , request one , this is invaluable to help you in the first few months of managing any form of Diabetes , as it helps you not just establish what your diet can be and your food energy needs before different types of exercise.
The early days with this condition you are advised to test your blood sugar a lot more than you do as you find your Controls. Both before and after a meal as well as first thing in the morning and at night , it helps you to know what your portion control needs to be and how much extra food you need to consume prior to physical activities.
My husband has been a Type 1 Diabetic for over 20 years . The diet we created for him over the years is equally right for various Type 2 conditions.
Lowering Carb content , eating Complex Carbs with a low Glycaemic Index , instead of simple "White" Carbs , and reducing MOST of the consumption of Refined Sugars and Processed Foods is key to it.
Not purchasing Diabetic Foods with Sugar Alternatives is important advice , these have their own problems , can affect your kidneys and your liver , and have some nasty stomach based side effects if over consumed. Sugar substitutes that are artificial , rather than natural ones like Stevia, are a No, No.
A small treat or portion of a normal food containing sugar is the better option , you can have it if you have been physically active or as a small dessert by making sure that this treat becomes the Carb allowance of your meal.
Increasing Slow Burning Foods in your diet reduces the extreme spikes and lows of your blood sugar without reducing your Insulin Sensitivity.
Proteins , Dairy, Nuts and Beans and Pulses , Wholemeal and Seeded products over White , Potatoes with skins , Brown Rice , Oats, Healthy Fats , and a good variety of vegetables and small portions of fruit , basically it's just the key elements of a Healthy Diet with smaller carb portions.
Each individual obviously has to cater for their size and body type and activity so there is no one diet or set of portion sizes to fit all.
It's closest equivalent is a Mediterranean style , more flexible version of LC /HF and Ketogenic systems .
The Fat content of these often being a little high for Diabetics whose Cholesterol levels are affected by their health condition no matter which types of Fat is consumed.
It can take a long time to find Your Diet for Life , especially as a Type 2 that may be fully diet controlled , but try to enjoy the trial and error involved in finding the right diet for You. Have fun with learning new cooking skills , trying recipes , and experimenting with new foods rather than thinking that these Diet changes are a chore that ' Has To' be done and the experience and change will be more Positive.
Food feeds the Soul as well as the Stomach so look at the things you enjoy and find how many of them can be adapted , eaten in limited portions , or had as rare treat and the Diabetic Diet can work wonders for you.
Good luck with it , if you want to ask any further questions feel free to PM as you go too.
Its really really hard to change your diet with portion control when you are on 60mg of Pred so Im finding but I am following your advice and checking my sugars more often, at my own expense at the moment as its also the wrong time of year to change your script. The story reminds me of that George Clooney film perfect storm. Im getting there now though just picked up my first prescribed box of strips, If I can work out what I need to change and then change 1 thing a week and start a taper as soon as is safe I may just nail it by summer lol.
You have to be really cautious about metformin. My sister ended up with stage 4 kidney disease because of that drug and may eventually need a transplant.
Hi as a type 2 diabetic I am interested as to what NIDDM is.
I was diagnosed about 2 months after my PMR diagnosis and have been in remission for about 2 years with an hba1c of 35. I do the LCHF diet and walk over 10,000 steps a day.
I sympathise...having been through the same...PMR diagnosed 2 months ago, and diabetes one week later! But I’m on a keto diet, trying to reverse the diabetes...lots of folk here on low carb diets, lots of info around, and if you search keto on Pinterest many recipes to help make life more interesting! But I need to lose weight, lots if it from previous steroids, you may just need a diabetic diet! Take care, I’m still in denial...but changing my ways...slowly!
Will have to sharpen up my quite lax low carb diet as steroids are raising my blood sugar levels, and GP is threatening to put me on metformin in the New Y ear
I second the advice to test which foods raise your blood sugars beyond safe levels. For you. Keep in mind that general diabetic dietary advice that recommends plenty of carbohydrates for the diabetic person are often concerned with low blood sugar levels for those on insulin. That would not be the case for a person taking Metformin. You want to take control of your own glucose levels based on how various foods affect you.
Test before your first bite of food. Then again at one hour. This should give you your peak rise, depending on the food. Test again at two hours. Ideally your glucose will be back down into a safe level. If a certain food raises your blood glucose too high, it is probably not a good choice as part of your diet.
Note that at 60mg of pred your pre-prandial reading may already be approaching an unsafe level, especially in the mid-afternoon. That's when it is most important to avoid any high-glycemic food intake.
About the diet and the numbers Mahnahvu what kind of numbers should I aspire to what is considered safe in a diabetic and what should I consider a problem ?
At the moment Im on 500mg Metformin morning and evening.
My numbers are around 5 to 8 in the morning which Im ok with then I have to eat in order to take my Metformin just some wholemeal toast usually as I never have much of an appetite in the morning that pushes my blood to between 10 and 12. The tea time reading is totally unpredictable sometimes as good as 5 just just as likely to be 20. Im trying to eat cheese in stead of chocolate with limited success but this 60mg of Pred makes healthy choices very hard in deed, also I have thrush so I cant taste anything leaving me starving even when I have just eaten, its like a medieval torture lol.
I am a type 2 diabetic and had stopped all medication with the Mosley Diet and well for years till I developed Polymyalgia. After diagnosis was put on 40mg Prednisolone which controlled the PMR but sent my dormant diabeties into orbit. My bloods were often in the 40s and even unreadable on occasions. Ive been on two different diabetic injections twice daily and metformin slow release 3 times daily. Now after a year Im down to 7.5mg Prednisolone daily and 20mg Methotrexate once a week for PMR and now only on Metformin for diabetes. All going in right direction with slowly cutting steroids. Only time will tell now easy does it.
First sorry you have to contend with additional stresses. I am the same mine is called prednisolone dependant diabetes 60mgs of pred for too long I had GCA. I am now a year later and down as of this week to 7 and a half mgs of pred. As for the diabetes I just try and follow what is loosely known as the rainbow diet ie known as Meditebrranean Lots of veg. of bright colours. olive oil. 4mgs of metaformin a day now I was not encouraged to check my levels although I know when first diagnosed they were very high as was my inflamation levels. Also now on methotrexate which has helped a bit. My problem has been balance co-ordination tiredness and thin skin. The latter quite difficult to deal with when one tries to be active. I know that the majority of people thank prednisolone for the reduction in pain as I did myself but I am convinced that for at least 10% of the population this drug causes or brings out many other unpleasant symptoms. Also the reactive nature on other meds when taken for many years with no previous problems is problematic and I don't think enough research has been executed or is under way on the clash of meds.
I do hope your appointment when it comes is significant for you. So far for me 2 different consultants in 6 months 5 mins each. Draw your own conclusion and do as you are doing write into this site its fantastic .
Thanks Valentina and to you as well it sounds like we are 2 peas in a pod. For me the biggest problem is not knowing how Im going to feel in 30 minutes let alone tomorrow so its hard to plan stuff like work, shopping chores etc without having to change plans at the last minute and I hate letting people down but what can you do.
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But steroid-induced diabetes isn't quite the same - for one thing, random BS checks can be misleading (pred triggers the liver to release random spikes of glucose, not related to food) and it WILL improve as the steroid dose reduces. Bee has given you lots of advice - and we have members on the forum who have brought their Hba1c back to normal just by diet. 
Methatrexate/hydroxychloroquine 
New to pmr, advice please 
My 7 Month Nightmare With GCA?
After an injury
