Sorry, this seems to be my day for asking questions. I increased my Prednisolone from 8mg to 10mg three weeks ago due to a bad flare. The pain and aching are much better now and I’m due to drop .5 mg to 9.5 in 5 days time. I’m a type 2 diabetic controlled with medication and for the past 10 days have been feeling exhausted and at times very ‘shaky’.
My question is can increasing your steroid dose mess about with your blood sugar levels? Has anyone else with type 2 diabetes had issues with their blood sugar when upping their steroid dose?
Thanks.
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Tiggy70
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It is very common. Not least because pred triggers the liver to release spikes of glucose from the body stored in muscle and liver. This is what leads in some people to steroid induced diabetes as the average BS level rises as a result. If a spike coincides with eating carbs it can go very high so you can have hyper-episodes. It doesn't happen to everyone and sometimes it is just at higher doses of pred.Did it occur to you to check your BS when you felt bad?
I’ve been testing more frequently over the past few days but the results don’t seem conclusive. For example I felt unwell at 5.00 pm yesterday and took a reading which was 14.5. I’d last eaten at 2.00 pm (a bowl of veggie soup plus 1 slice of bread). Today prior to my lunch I felt unwell again, took a reading and it was 8.2. I think I may need to contact my diabetic nurse to see whether my medication needs adjustment.
When I asked a Rheumatologist what was a ‘safe’ level of Prednisolone, he paused and then after thinking for a bit said 5mg. I have a follow up question if you don’t mind, PMRPro (or anyone in fact), at what dosage of Pred. does the concern about blood sugar become minimal? Or is that one of those ‘how long is this piece of string’ questions? I guess I’ve almost answered my own question.
I think it is - I'm on over 15mg of pred and have been for a long time but as far as I know my BS is fine - BUT I do eat very little in the way of carbs. Everyone is different which is why keeping an eye on the Hba1c is a useful monitor even if it isn't perfect.
My last HBa1c test conducted 13w ago was 42. But I’ve been a bit naughty recently having 1 glass of red wine a day. I’m currently transitioning from 6 to 5.5mg using DL’s celebrated tapering schedule. I suppose it’s time to ask for another test.
I am type 2 and not on medication. I was concerned when I had to go back up to 9mg from 4mg that it would raise my blood sugars. Fortunately it doesn’t seem to have made much difference
That’s good that increasing the steroids didn’t affect your blood sugar. Maybe it’s something to do with being on medication. Since being diagnosed with PMR I’ve had to double my Metformin dose and add Pioglitazone to the mix😩
Very good to hear prednisone at a higher dose did not affect your blood sugar. I have type 2 diabeties and am not on medication. My weight is good and do well esting healthy with less carbd. However, since my steroids increased from 15 mg to 30 to deal with inflammation, I began noticing an increase in my glucose level. Even though I went to 15 mg, I continued with raised sugar. Tried a lower dose of 10 but began feelin unwell--thus 15. Prednisone also increased blood pressure. It disheartening.
I’m not quite sure what you mean. I’ve been taking more regular pin pricks tests particularly when I feel shaky. The results have been variable. Sometimes there is definitely a spike but at other times my result is in the normal range. Do you mean the hba1c when you say glucose levels?
I had type 2 diabetes before being diagnosed with Palindromic Rheumatism. Regrettably the NHS stopped providing me the means to test my blood sugar levels. But I do know that Pred does raise blood sugar levels.
As I mentioned previously I’ve had to increase my diabetes medication since being diagnosed with PMR and taking steroids. Also my hba1c has risen over the past 15 months (from 47 in August 2020 to a recent level of 63). This is despite trying to keep my carb. intake low. I may have to be even stricter with myself and have less carbs. I just get so hungry when I reduce even lower and succumb to biscuits and the bad stuff😖
You maybe need to be more aware of what and how much you are eating - if you cut the carbs enough you won't get as hungry because you reduce the roller coaster of high sugar levels triggering too much insulin which makes the BS level plunge too low and so you crave carbs to bring it back up again. Lots of people think fruit is healthy - it is, but not in the context of a low carb diet. If like Snazzy and me you need a very low carb level to keep things in check, just a single apple or banana of the size sold these days takes you to that level without anything else. Weighing and working out what you are eating is essential sometomes to work out where you are.
Thanks. I do need to take a serious look at what I’m eating. I’ll have a look at some of the low carb eating plans on the forum. I’m not a big fruit eater although I do love it. I usually have some berries with my breakfast cereal and one small apple or satsuma later in the day. My diabetic nurse has told me I shouldn’t be eating porridge oats for breakfast as they contain too much sugar. In the winter months I love a small bowl of porridge as it keeps me going until lunchtime. She told me I should be having Weetabix or shredded wheat. Is she correct?
I personally don't think so - but I wouldn't eat her choices anyway as they are wheat and I have an allergy to the starch in it. She MAY mean the ready prepared quick porridges - if you buy plain oats and soak them overnight or cook slowly in the microwave with water the sugar level is not high. You need a big bowl and cook them on a low setting so they don't boil over. I would never add sugar to porridge, I usually cook it with water and salt - did this morning as there was a small amount left from my daughters being here so I used it up!
Oatmeal is good enough for the American Diabetic Association
I don’t tend to use the little packets because of the added sugar. I use 3 dessert spoons of Quaker rolled oats mixed with a little semi skimmed milk and then microwave for 2 minutes. I then add a little runny honey and top with a few blueberries and raspberries. I’ve never tried porridge with salt although that’s how my Scottish son-in-law makes it. Maybe I’ll give it a try😝
I bet your nurse is thinking of those little packets of oats which only need the addition of water to be eaten. I don't like them. Milk and salt on home-cooked oats for me!
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