PMR + type 2 diabetes

[Kalacik]

Diagnosed with pmr last week and after IV prednisilone am now on reducing plan. Problem is my type 2 diabetes, which has been under control for 5 years with keto diet, has gone crazy. I’m having mood swings and struggling to know what to do to help myself. Previously the diabetes meds fought with my other meds and made me feel so ill. Any help please

[SnazzyD]

Hello and welcome. Just a few questions to help others advise. What doses did you have and what are you on now?

What do you mean your diabetes meds “fought” with others? What were they and what happened?

Pred can make one very emotional in all directions but it does improve as the dose reduces. Some people take medication to help but most ride it out and wait for better days that do come.

Do you check your blood sugars then? What readings are you getting whilst on your Keto diet as well? Normally an ultra low carb diet keeps things under control but not always for some. The Pred makes the liver release glucagon from its stores to make glucose in the blood so we normally get spikes in blood sugar on Pred, which is why we try to keep the dietary levels down to a minimum.

[Kalacik in reply to SnazzyD]

Thanks for replying so soon. I was on IV steroids for3 days and now on reducing dose of 60 mg down to 10.

I have other autoimmune conditions (PBC Sjorgens) for which I take meds. Others including heart tablets. When I was taken diabetes meds they all made me so ill but as soon as I controlled by keto it was fine. My blood glucose was usually between 85 - 105.

Can you suggest a different diet for now?

[Koalajane in reply to Kalacik]

What are your blood sugars now and what dose of pred are you on now?.

My feelings are that when your pred dose lowers your sugars will too and that your diet should do the trick. I am now on 5mg of pred and control my type 2 with a LCHF diet. I have done since being on 10mf of prednisolone. Good luck

[Kalacik in reply to Koalajane]

Thanks so much you have given me hope. Currently I’m on 60 mg and reducing over 5 weeks.

[Koalajane in reply to Kalacik]

I have to say for PMR that is a high dose.

[Kalacik in reply to Koalajane]

I was so ill a week ago and fatigue (which I Also have from my other problems) left me unable to function. I think my doctor just wanted to zap it quickly

[DorsetLady PMRGCAuk volunteer in reply to Kalacik]

Still over the top for PMR - 25-30mg probably would have done the job - but it is what it is.

[Theziggy]

I had and have Type 2 diabetes long before I had Palindromic Rheumatism. Had controlled it with diet and exercise to the extent that my GP told me "Your recent blood tests would tell me that you don't have diabetes - you have it so well controlled"

Sadly prednisilone has tamped up my blood sugars (I don't receive any means of testing my BGs on prescription)

So in answer to you - Pred does screw up ones diabetes control !!!!

[Kalacik in reply to Theziggy]

Glad I’m not alone but it’s so hard to relinquish once you’ve had control of your diabetes

[PMRpro Ambassador]

Are you sure your diagnosis is PMR? You have been given treatment that is usually reserved for cases of GCA and really rather inappropriate for PMR, especially for someone with diabetes already. That is a really high dose of pred - I'm not surprised your sugars have gone mad.

I felt pretty awful without pred - but 15mg worked a miracle in 6 hours. And the pred really doesn't do a lot about the fatigue - that is a component of the autoimmune disorders, don't know of any where fatigue isn't a factor.

[Kalacik in reply to PMRpro]

Hi I’ve been dx with polymyalgia rheumatica and I wonder if the treatment is different as I live in North Cyprus. My Doctor is brilliant and trained in London. She has seen good results with fatigue in the past starting with the high dose. Thanks for your help

[PMRpro Ambassador in reply to Kalacik]

Probably your doctor doesn't have to comply with standard protocols. But I don't think many experts would agree that PMR ever should require that sort of approach