Pred has led me to Diabetes!

[Silver-Babe]

I was warned that I was borderline diabetes when I started PMA at the New Year. So one month of 15mg. Of Pred. Has resulted in my haemoglobin rising to 49, which means I am now suffering from Type II diabetes.

So it goes on! Has anyone else had this problem? Trouble is it is early days with my PMA and I could easily be on this dose for a long time which will push it even higher. I am on the keto diet – but it is not recommended long-term for diabetes – and have lost already 13 lbs. which is great. Any advice would be much appreciated.

[SheffieldJane]

That is brilliant Silver-Babe, 13lbs!). Mine came down again with Pred reduction and cutting sugar/ carbs but I’m getting thirsty again.

[Silver-Babe in reply to SheffieldJane]

So did pred cause your diabetes Sheffield Jane? (my name too without Sheffield) I hope I can reduce my pred soon, but probably too early yet as I'm only in my second month now. But I have no symptoms of diabetes as far as I know. Are permanently cold hands and feet symptoms do you know? How thirsty do you get? what is normal thirst and diabetic thirst?

[SheffieldJane in reply to Silver-Babe]

Hi JaneMy Rheumatologist referred to it as steroid induced diabetes. I assumed that the thirst I experienced was related to my high glucose readings. I do not have cold extremities. My last blood test showed completely normal readings . There is no diabetes in my family. In my doctor’s surgery there is a “Diabetes “ nurse. She has signed me up to receive various guidance/ recipes that I still receive. I believe there are meetings under normal circumstances.

[Silver-Babe in reply to SheffieldJane]

Hello Jane, Yes, I too am seeing my GP diabetic nurse next week too. She seems very switched on so I am sure she will answer my outstanding questions. Thank you for keeping an eye on me!

[DorsetLady PMRGCAuk volunteer]

It happens, but more than likely once you start reducing blood sugars will return to a more normal level.

The weight loss is great, but that can continue with a more ‘diabetes’ friendly diet. Plenty advice online (see link), or get number for local diabetes clinic from GP.

diabetes.org.uk

[Silver-Babe in reply to DorsetLady]

Yes, thank you Dorset Lady. I'm following every angle

[Koalajane]

I didnt go keto but use the low carb high fat diet and this put me into remission. My sugars still spike about 4 hours after taking the pred and this lasts for a few hours. I am on 4.25mg now and it still spikes but not nearly so much. I have had PMR for 4 years. I was first put on gliclazide by my doctor but taken off it on my first diabetic review 3 years ago due to low hba1c. It is now controlled with diet and exercise. I still have a diabetic review which I am happy about as I find out my hba1c and also get a full lot of blood tests which is very helpful. I have this every 6 months so always ask for my ESR as well

[Silver-Babe in reply to Koalajane]

You are so more advanced than me. Sign of things to come for me......... Thank you for your interesting reply. Noted.

[PMRpro Ambassador]

While the keto diet may not be recommended long term for diabetes by some, the low carb approach is and diabetes.co,uk seem happy enough about it.

diabetes.co.uk/keto/

In fact, it is pretty well impossible to get into ketosis when you are on pred as it causes random spikes of glucose to be released into the blood stream by the liver and you cannot control that. You can only do your best.

Steroid induced diabetes is not the same cause as Type 2 diabetes - once the steroid dose falls, so will the HbA1c reading. 48 is the target for diabetics to aim for - you aren't far out at present. We had a Type 1 diatetic on another PMRGCA forum who did a lot of experimentation and testing and he found that going for a walk/exercising after a meal or an hour or so after his pred dose kept the peak blood sugar levels down.

Very well done on the weight loss!

[Silver-Babe in reply to PMRpro]

Thank you Ambassador. Yes, it's true I can't get into Ketosis, hard as I try. Now I know why. Does this matter? I this why I am finding it difficult to lose my last three pounds, hard as I try? And I am walking every day - except today, too freezing! But I'm doing up to 2 miles a day, unbelievable for me. Having GP blood test on Tuesday so keep your fingers crossed for me me please!

The only trouble is that a diabetic consultant who I know, says that they don't like us taking in too much fat, because it causes cardio-vascular problems and I already have AF. What's your theory on fat and heart and diabetic problems? Sorry for the difficult questions but you seem to know the answer to everything!

[PMRpro Ambassador in reply to Silver-Babe]

Ah well, I ascribe to the Aseem Malhotra school of cardiology which doesn't believe the fat and heart disease link. I don't think there is any link between fat and AF - it is an electrical problem not a plumbing one if you see what I mean.

There has always been a thing about not eating too much fat when diabetic but I don't think I necessarily eat a lot of fat, just lots of veg and some protein but not anything like as much as a lot of people do as I never eat more than 4oz/100g of meat, bit more fish usually. I'm not diabetic so not really up in the fat aspect of diet- but I do know the mind set has changed dramatically over good diets for diabetics in the last few years. Newcastle has done a lot of work into reversing Type 2 diabetes and it is becoming mainsteam now.

[Silver-Babe in reply to PMRpro]

That's good news Ambassador. I think you are right that AF is electrical rather than plumbing. Good analogy! The Keto diet is dependent on sufficient fat intake. There I've been for years, like thousands of others, following a low-fat diet, but I never lost much weight by doing that. They ply everything with sugar, which is the last thing I should have now I am just diabetic. So thank you - back to my olive oil and even double cream!

[Theziggy]

49 is more pre-diabetes than full blown diabetes. Try cutting down on carbs and the walking exercising after meals is also a very good way to cut down glucose spikes after meals.

[Silver-Babe in reply to Theziggy]

Yes, thank you. See my reply above to Ambassador

[York54]

I too have diabetes induced by prednisolone. My last diabetic review was in November 2019, my surgery wouldn’t see me last November. Last result my Hb1ac was 48, the nurse was pleased and told me to keep doing what I was doing! Low carb diet and plenty of exercise. I am also taking metformin and lost over a stone in weight. Finally having my bloods taken and review next week so fingers crossed I have lowered my blood sugar even more. I’m now on 3 1/2 mg pred.

[Silver-Babe in reply to York54]

Well done York 54! Trouble is I am on my second month of 15mg Pred, so I can't see my hb1ac going down for a while yet, while I'm at that level. I know this is Pred induced. I'll keep you informed, but please keep an eye out for me on this forum, because I don't think there are many who have this complication of Pred.

[York54 in reply to Silver-Babe]

Will do x

[Darcy2000]

I headed in that direction and went from 7.7 ( Canadian values) to 5.0 in 6 weeks by completely giving up sugar.my Pred was at 25 And now at 12.5

[Theziggy]

I had diabetes type 2 before pred. I have slipped off the low carb/exercise regime for a few years and haven't had bloods done for the diabetes for years but I do know that Pred pushes Blood Glucose levels up!