Steroid induced Diabetes and Flare

[Knitwit2020]

Yesterday was told I have developed Steroid induced Diabetes based on a Hbg a1c1 results. Prescribed Metformin..was pretty upset yesterday. Have been completely pain free since starting 20 mg of Prednisone in June gor PMR AAhave used the DSNS method of tapering got down to 10mg last week with no problems....but woke today with extremly sore achy triceps ..stiffness around shoulder girdle...so is this a flare or a temporary reaction to yesterdays news..Took extra 2.5 mg so total 12.5 mg this am ..what is the standard amount one takes during a flare if this is in fact a flare..thankyou best to all..Knitwit2020

[MrsNails]

Hi

Have a look at this, you may find it helpful.....

healthunlocked.com/pmrgcauk...

MrsN

[Knitwit2020 in reply to MrsNails]

Thx Mrs N for your response.lovely dress by the way....but not clear if this is a flare in response to stress and need some quidance on amount of pred to take.

thankyou KW

[MrsNails in reply to Knitwit2020]

Hi, l was in the middle of working on an Advent Calendar & l had that link ready to go as l’ve just forwarded it to someone else.

I see Pro has replied about maybe you’ve overshot rather than flared, sometimes a tricky line.....

I had the Dress for the Recipient of The Advent Calendar, my beautiful Granddaughter’s Christening & it’s pleated from the waist & finishes just above my ankles, it was a very tight squeeze last year 😉

Regards

MrsN

And as Pro asks what is your Hb1Ac? Mine was 47 just one point off Type2 Diabetes (48)

[PMRpro Ambassador]

Do you know what your Hba1c figure was? One of the things we go on about on the forum is to cut carbs drastically, especially processed foods and added sugar. Often that will be enough to avoid developing steroid-induced diabetes and to have got to that level in just 3 months does suggest you had a fairly high Hba1c before anyway.

I wouldn't call it a flare - just you have overshot the dose you need to manage the inflammation at the moment. It will be a flare if you had ignored the warning and stayed at 10mg. The pred hasn't cured anything - it is just a management strategy to allow you a better quality of life until the cause of the symptoms has burned out and gone into remission. You aren't reducing to get off pred yet but looking for the lowest dose that gives the same result as the starting dose. 10mg is a bit low yet - 10.5mg might be enough if if you reduce in smaller steps you will very likely get lower than 12.5mg. Once you feel OK again, try going down by 1mg at a time - do you have 1mg tablets?

[Knitwit2020 in reply to PMRpro]

Thankyou PMRpro...my Hba1c has been gradually increasing over the years...just below 6 ..but in 4mo of prednisone use it has increased to 6.7. I have a strong family hst of type 2 diabetes. I recently loss 44lbs on a keto type diet which was recommended by my Rheumy to give my weightbearing joints some relief..some weight has crept back on but generally speaking I eat a pretty healthy diet...but several of my arthritic meds have the side effects of weight gain..so its been a struggle. My Dr has prescribed the hypoglycemics to prevent this turning into a full fledged Diabetic scenario..he will monitor my blood work every couple of months..interesting my husband is a diabetic as well, not a typical type 2, as he is normal weight and very fit..the endocrinologist refers to him as her type 1 1/2....and while testing with his glucometer I was a normal 5.3.

I think my aches and pains today are directly related to the upset from yesterday...by taking an extra 2.5 mg I was hoping this will settle things down again.

As stated the 10 mg was working for me ..I had no pain ..the only thing I have suffered with is extreme fatique which now I see may have been a combo of the PMR and high blood sugar..thankyou again for all of your advice.best to all..KW 2020

[PMRpro Ambassador in reply to Knitwit2020]

The fatigue is part of the autoimmune disorder - and pred doesn't really do much for that except at higher doses when you may get the "pred gives you wings" effect. Never did anything for me!

If I were you I'd go back to the keto-type diet - having done so well before, straying from it will mean you tend to put the weight back on. When you are on these dratted drugs it isn't something you can do for a few months and then go back to the previous eating habits. Healthy often means fruit and wholegrains - but they are all carbs and don't mix well with pred.

[Ann1A in reply to PMRpro]

Please, is there a post somewhere that contains an idiots guide to the terminology, and best practice. I am new to this condition and am currently a little confused by some of the terms.

Many thanks

[PMRpro Ambassador in reply to Ann1A]

There is a post in the Pinned Posts where MrsNails listed many of the acronyms that you see a lot. As for best practice - I don't think even doctors agree on that! But to be honest - asking about acronyms is probably as easy if you can't find it with google which often does work.

[MrsNails in reply to Ann1A]

Hope this helps 😊

healthunlocked.com/pmrgcauk...

[AdoptMeow]

It wasn't mentioned if you actually had taken the Metformin the day it was prescribed, but I can tell you that I tried it three times and each time I felt so bad within a day or two that I stopped taking it. I was diagnosed with PMR 27 months ago, started on 40 mg and now on 10 mg.

Metformin was prescribed when A1c was 6.7. Last year it ran 6.1 with a more healthy diet. Last month it was 6.0. I suspect the high reading was at least

partially due to having a steroid injection in my back shortly before the bloodwork. Are you feeling better the increased prednisone?

[Knitwit2020]

Just saw your response thankyou for asking...No I had not started tbe metformin at that point...I did increase my Prednisone that day up from 10 to 12.5mg it made a big diffetence..the next day I dropped back to my 10 mg..wasnt sure if a start of a flare or just am immediate stress reaction to the new dx.Am continuing to taper the Pred on Monday plan to drop to 9 mg..will see how that goes.

The fatigue I am experiencing is I think a combination of the PMR, tapering the prednisone and the elevated blood sugar..the metformin is being added very slowly as I am taking so many other meds that can produce more GI upset...so 1/2 tab x 4days then 1 tab for 3 days then two tabs per day total 1000mg.

Today has been a bad day..lots of abdominal pain and nausea ...but will give it a few more days..I do have a virtual mtg with the Diabetic Educator on Tuesday and we will review my ability to continue to take the Metformin.. so onward we go..

Take care ..stay well..KW2020 thx for your post..