High risk of developing type 2 diabetes

[jinoadby]

Hi.

I need some reassurance. I was diagnosed in mid-July with PMR and was put on 15mgs Pred. My doctor (who I like and who listens to what I want) kept me on 15mgs for 2 months and then agreed with my decision to drop by 1mg every 4 weeks. After reading all I could on this forum, I decided I would rather go slowly and put up with the side effects of Pred, rather than risk bouncing up and down.

But, the steriods have now affected my blood sugar levels and I am within an ace of tipping over into type 2 diabetes. My doctor has arranged for me to see the diabetes nurse in a couple of weeks, and has strongly recommended that that I drop from 12 to 10mgs next week instead of to 11 as I had intended. I understand why she is saying this, and agreed to do it. This means that in mid-Dcember I will then be going down to 9mgs. I am next speaking to my doctor at the beginning of December, and am worried that she might pressure me into dropping to 8mgs instead of 9, and I am unhappy with the the the idea of that.

I would appreciate your thoughts. Thank you.

[jinasc]

I have an article on the relationship by a Leading Diabetes Dietition on Pred and Type 2 Diabetes and how to avoid it or get to go away. If you want a copy, a pm with your email address which will be deleted after the article is sent to you.

Check my profile before you decide re email address.

[SnazzyD]

Hello there, have you done anything with your diet, for example the very low carb diet? The normal idea of a healthy diet doesn’t cut it with Pred for many people and cutting out most carbs is the only way to go to avoid magnifying the tendency of Pred to cause an increase in blood sugar even before you eat anything.

[DorsetLady PMRGCAuk volunteer]

Just because you are pre diabetic doesn't automatically mean you will become diabetic……many border on the edge, I did initially on much higher doses than you…but as I lowered the Pred, my blood sugars returned within normal range. Hopefully yours will too.

[Lafontainepam1 in reply to DorsetLady]

That’s good news to my ears!! I am down to 7 from 15, I was put on meds for diabetes a couple years ago, so keeping my fingers crossed. I’ve had PMR for 10 years!

[Koalajane]

Hi, I was diagnosed type 2 diabetic about 5 months after my PMR diagnosis and put on meds. I changed my diet to a low carb one and on my first 6 monthly review was taken off the meds as my hba1c had dropped. I have carried on with my diet and 4 years later am still in remission with a hb@1c of 37. Good luck to you.

[jinoadby]

I was diagnosed as prediabetic 4 years ago and have remained stable at the bottom end of the prediabetic spectrum by watching my diet. I have, just this week, shot to the top of the spectrum. It is not only the possibility of getting diabeties that is worrying me, but also of having to taper harder and faster that I wanted to.

[jinoadby]

unfortunately my hba1c, which had been stable at 42 for four years, has shot up to 46, and I believe that 48= type 2 diabetes.

[PMRpro Ambassador]

Steroid induced diabetes is not quite the same as Type 2 diabetes - it is due to the pred making your body release glucose into the bloodstream from the body stores in muscle and liver. That means it adds to the glucose you get from eating carbs of all sorts but processed carbs are a big culprit because they release glucose quickly

Cut your dietary carbs, especially processed one, a lot. There are a lot of people on the forum who have got their Hba1c back to an acceptable level just by doing that.

And I really wouldn't risk jumping the reductions like that - you run the risk of the inflammation increasing and you having a flare which would require MORE pred if it was too bad.

[jinoadby]

Thanks everyone, I shall take on board what you all say.

[SheffieldJane]

The same thing happened to me and I was able to normalise my blood sugar levels with a stricter diet and more exercise. I continued a normal taper, knowing that a flare would lead to a higher dose in the long run. The doctor seemed surprised. I wonder if steroid induced diabetes is easier to remedy?

[mgrogers99 in reply to SheffieldJane]

It's only easier to remedy because of the goal of getting off prednisone!! Physiologically it is not the same challenge. I have steroid induced diabetes and for various reason use insulin. My doctor says when I am off the steroid, the diabetes will go away....am tapering now for the 4th time and it is going well. I never could get below 9mg and will be on 10mg in a few days.

[Meggsy]

I have eaten low carb since starting 25mg pred three and a half years ago and blood sugar has remained stable, no rise in BP or weight gain. I do allow myself some weekend wine. All the best. 🌻

[agingfeminist]

try cutting the carbs not the pred. The pred you need, the carbs you don't. I surged into prediabetic on initial dose of 60mg of steroids for a month, Then deleted the white carbs...no sugar, no flour, no potatoes, no rice...now use date syrup to sweeten the cakes I make (with ground almonds). No premade food (has hidden sugars and other gunk). Can't easily manage the exercise...but cooking and cleaning are my daily exercise.

Not prediabetic anymore.

wishing you every success!

[Viveka]

As people have said, it is possible to reverse prediabetes through diet. I went from just below prediabetes to top of prediabetes in July 2021 after 4 months on pred (40 to 17.5 at four months.) I was fed up about the thought of changing diet but it has been a real positive. I cut out white carbs and went down to just under the RDA for carbs, and I cut out 75 per cent of sugar also going to just below the RDA. When I had the follow up test in Oct I was pleased to be back under prediabetes. I had also reduced to 8 pred so not sure whether it is diet or less steroids or bit of both. However, as I said, it is really positive and I am sticking on the way of eating . I have lost a bit of weight and intend to lose more. I don't miss sugary snacks but know that if I want a treat, like for my birthday, I can do it guilt free. Michael Mosley reversed his prediabetes and has great food tips. Of all the horrible things about this illness, I have found this one a positive!