Zoe Programme

[kalgoorlie]

I am lucky to be participating in the Zoe Nutrition programme. As part of this my blood glucose is measured constantly via a sensor on my arm.

I understand that prednisolone affects blood sugar. I normally take my pred with breakfast. But I have pushed taking my dose back to late afternoon during the 14 days of Zoe testing as I think this will minimise its impact on the food eaten vs. blood glucose curve tests which are mainly at breakfast and lunchtime during the day.

I am currently taking 6mg pred per day and have no other health issues, not diabetic, nothing. I do not suffer with any PMR side effects at any time of day, I generally feel fine, so pushing the pred to a different time is fine for me. (so far so good!). I am following the fairly standard tapering, 1mg every 6 weeks .

I have some questions.

Do you think the pred could still affect my test results during the day or am I on the right track with pushing out the time I take it so that its affect on the tests is minimal?

Going forward and as I taper further is it better to take the pred before I go to bed at around 11pm? (I do not want to wake up and take it at 2 or 3am like some of you) . For the couple of days before I pushed out the dose I noticed that my blood glucose dropped quite low overnight to around 3.8 mmol/l in the early morning but then rose to over 4 after I woke up. Since pushing out the dose my early morning blood glucose has been around 4 or 4.1 mmol/l . During the day after eating it does rise to levels averaging 5.5mmol/l

So I'm thinking generally 11pm ( or when I go to sleep but it's generally around that time) may be a better time for not only blood glucose impact but curbing any possible PMR flare as I taper, as well as better for adrenals waking (althougb I have not noticed any of the adrenals waking side effects yet).

Comments welcome and I'd be interested to know if anyone else is doing the Zoe programme!

[PMRpro Ambassador]

I suspect that when it most affects the readings depends on the person. I think it is Koalajane who has worked out when her BS spikes and she avoids eating in that period. The spikes are random - difficult to say when really.

In terms of adrenal issues - the adverse effects are more if they aren't waking up rather than that they are. The later before or soon after midnight you can take pred the better in that context - a nadir at midnight is the trigger for cortisol production the next morning. Plain prednisolone takes about an hour to reach its peak, prednisone take about 2 hours since it must be processed by the liver before being active in the form of prednisolone.

With regard to PMR flares - shouldn't happen as long s you are on enough pred. Adrenal function doesn;t really impact there.

[Griggser]

my wife and I are both on the Zoe program and have completed the glucose monitoring and are now on day 7 of Zoe 201. We both have found it to be quite enlightening. It’s certainly making us look carefully at what we are eating. We’re trying to keep our Zoe scores over 50 at the moment and enter foods in prior to eating to see how they score. We’re also building a library of recipes to help us decide what meals to have each day.

[Bluemoonbrummie]

I’ve just received my Zoe nutrition testing kit and plan to start on Friday. I’ve been wondering about whether my pred dose currently 12.5 mg will affect the results. Giggster - did you continue to take your pred in the morning as usual?

[cranberryt]

The entire purpose of the Zoe program is to teat foods amd times to see how it affects your blood sugar. So if that is something that concerns you, test it by moving the prednisone timing around and see how it impacts your sensor. I didn’t specifically test prednisone timing when I did the GM so I cannot share personal experience.

[Mahnahvu]

My experience with random testing (not using a CGM) and taking my pred at 9:30 am, suggested that I get a bell curve in the middle of the day, highest raise in blood glucose from noon to 5pm.

[Rockborne1920]

Hi Kalgoorlie,

I can only speak for myself, so I have GCA and have been taking Prednisolone since April 2021 on a reducing dose starting at 40mg. I have had a few problems on the way down but have now got down to 4mg. At the very beginning when I was taking Prednisolone after lunch, I suffered with panic attacks and disturbed sleep. The consultant was aghast and told me I should have been taking them first thing in the morning so my body had time to absorb them! (I was never told when to take them)I changed and have had no problems since. Yes, it does affect your blood sugar but I have regular blood tests and my sugar level is okay.I want to avoid having to take Methatrexate so am reducing by1/2mg a month as the consultant said do it really, really slowly, so fingers crossed! for me and you.