I am wondering what other member’s experience has been with prednisone and increasing A1c levels? I had been very consistently in the normal range for long term blood sugar levels until I started the prednisone last August. Since the prednisone, my levels have gradually crept up into the pre-diabetic range, heading towards diabetes. I eat a fairly strict Mediterranean diet with very low carbs, but my A1c level still increases each time I have it tested. My question is, even if I reach the diabetic range, when I am on much lower levels of prednisone or off of it altogether, will I no longer be diabetic? Is it different for those of us who have prednisone induced type 2 diabetes from those non-PMR people who get type 2 diabetes? I would appreciate hearing about our member’s experiences with rising blood sugar levels. Thanks!
Prednisone and Blood Sugar Levels: I am wondering... - PMRGCAuk
Prednisone and Blood Sugar Levels
I am in exactly the same situation as you. In fact, I'm going in next week to see if my recent pred reduction was enough to keep me prediabetic. If not, I'll have to go on something.
I do believe if it's reversible. If I manage to reduce pred, lose some weight, etc., I should go back to prediabetic eventually.
Thanks for your reply. My brother was recently diagnosed with Type 2 Diabetes and was freaked out enough to lose 26 pounds and eat almost no carbs. His Alc is now back down to low normal. However, he was told that even though he has “reversed” his diabetes, once you are diabetic you are never “cured.” So my question is for those of us whose “diabetes” is prednisone caused, does the same hold? So even if we manage to reverse our high blood sugar, will we still have diabetes even after we are off of the prednisone?
I suppose it's like PMR. You can be in remission, hopefully permanent remission, but no one who ever had PMR is ever really "cured".
I have twice gone back to my pre steroid induced Diabetes, coming off Metformin and maintaining a normal HbA1c when I managed to reduce to 5 mg. But twice I had a severe relapse and the Diabetes came back on high pred doses. It’s a guessing game if it will go away again…hope so.
Yes. Former Dr only did random test, but new one says my level is just at the number above which they'd have to do something. I have no idea how things are now as it's been about 10 months since last tests. I'm trying to hold out for a full year as he kindly took on one of my sons as a patient when his doctor left the country, even though no one in the practice is taking on new patients! Trying to be less of a burden on the medical system.
I’m on 6.5mg Pred (5 years since starting pred). My HbA1c is in Prediabetic range. I understand steroid induced diabetes will reverse for some people once steroids reduced/stopped. However some people remain diabetic (maybe its if you are susceptible anyway) I do check my blood sugar and notice its normal on waking but rises at lunchtime (a few hours after pred) I now avoid carbs midday and try to keep to small portion in evening too. This seems to help control blood sugar. I can get away with eg toast at breakfast but if I had it midday my sugar would shoot up! Low carb (not no carb) seems to help me. Also not eating after 6pm has made a big improvement. Blood sugar is better when I go to bed now. Its not always easy but I do try. Am hoping my HbA1c has come down next time its tested.
Thanks for your reply! Do you check your blood sugar with a finger stick? If so, you are a braver soul than I. Although maybe I should screw up my courage and do it so I have a better idea of my daily pattern.
Your suggestions about small portions and early dinner are something I’m working on but haven’t yet achieved. I appreciate the reminder. What time do you take your prednisone?
Yes I use a finger prick device - its helped me see how I respond it different foods. There are some surprises! You soon get used to it and I do it less now I know. I do eat lots of veg/ salads and protein. I don’t worry about fats either - full fat yoghurt etc. It helps fill you up. I take my pred when I wake around 6.30 - 7am. Might go back to sleep for a bit if I want or at least relax in bed a while. The other thing eating earlier in evening helps with is sleep! Thats another issue for me with pred - maybe getting older too I suppose. Also I don’t worry about the odd time I go out socially etc - obviously eat later then. Life has to be worth living 😁
Hi Donna, I've been on high doses of pred since August of 2019 and now I am down to single digits. Both my father and brother were diabetic. Yes, I watched my sugar climb (and my body weight). Twice I have been in the hospital and received IV Solumedrol; while receiving that I had to be given Insulin. THE GOOD NEWS IS....the glucose level came down. At one point, a physician I no longer have, wanted me to go on Metformin and I refused. The pred is such a blessing and a curse...I didn't want the Metformin. I ate nothing that was white...nothing and as much as I love ice cream...no more. I am fine. You know? There is so much we have to think about... we do... and we make it.💞
Thanks for your helpful reply! I am still working out my diet and hopefully in the right direction. One problem is that I have for years used prunes before bed to improve digestion (they work well for me) but apparently they are not a very good choice for blood sugar, especially before bed. I have started taking them with some almond butter for fat and protein, so maybe that will help. This disease definitely causes us to have to strategically use our brains, which may in the end be good for us.
Yes indeed, managing is a full time job that hopefully becomes a habit~!💞
I've just responded to another post about blood sugar levels and keeping the digestive system moving. You could try taking vitamin C to bowel tolerance and following a ketogenic diet, then reduce the vitamin C to just below bowel tolerance and keep an eye on it. Your need will fluctuate. To understand more go to: drmyhill.co.uk/wiki/Vitamin....
I am not sure whether the link will work but Google Dr Sarah Myhill - vitamin C and that will take you to it.
Hi. My Hba1c was 42 before pred but shot to over 50 overnight when on 30 mgs. Doc was going to give me a home blood testing kit and strong drugs. Diabetic nurse said I did not need them and simply prescribed 500 mg Glucophage and moderated my diet. I cam down as the pred reduced and was at 44 in April last year so prediabetic.
did you look in the FAQs? Or search on this topic? It comes up regularly, & a lot of us have had steroid induced pre diabetes, or diabetes. Sorry, Coronation Day rules, no time to rewrite my experience yet again, but do try those sources…you should find a lot of info!
Whether you stay diabetic depends. Having high blood sugars doesn’t mean you are diabetic but having constantly high blood sugars can make you diabetic. Pred makes the liver convert its stores of glucagon into glucose whether you’ve eaten or not. The body reacts by putting out insulin because it doesn’t like high sugar and your cells need some of it for fuel too. If you eat carbs it just adds to the glucose circulating on top of what comes from the liver. Lower your carbs and/or lower the Pred and the whole effect is less so you go back to normal.
But, it might not go back to normal if you’ve tipped over into diabetes. This is when you can no longer adequately produce the insulin needed to clear the blood and this can happen when the constant high blood sugar makes the pancreas over work and it becomes exhausted. You then need medication to either replace the insulin or help the pancreas work better.
The other thing that can happen is that with constantly high blood sugars and extra weight gain is that your body doesn’t use insulin so efficiently. This insulin resistance can have the same effect on blood sugar in that it just goes up. There is strong evidence that losing weight can reverse this.
So, if you keep on with a carb laden diet and Pred your pancreas may have given up by the time you get to lower doses and if your weight gain is appreciable you might have insulin resistance as well. If your blood sugars are already showing an increase it doesn’t mean you are diabetic yet but the levels are as high as someone with diabetes and that brings the usual risks with it. Best to try hard to prevent all scenarios and keep control of weight and blood sugar as much as possible with low carb and hope that by the time the dose drops your body goes back to normal.
Thanks so much for the comprehensive reply. I am one of the paradoxical people who actually lost weight when I started prednisone and now at 9MG have maintained my normal weight. So it isn’t weight gain that has caused the rise in blood sugar. But I’m still fine honing the timing of and amount of food I eat at meals. I have also been doing a bedtime snack for years consisting of 4 prunes for digestive efficacy and now some almond butter to add fat, but I’m thinking I may need to give that up.
Hello, my husband got Diabetes induced by Prednisone four years ago. He has always been at a perfect weight. His blood sugar goes up to over 300 at night and during the day it is under 200. He is on Metformin. Is it possible for his diabetes to reverse?
Possibly, but it depends on the individual, so it is a question for his specialist really. Is he still on Pred?
He has been off for 4 years
So if he’s on Metformin he is still able to make some insulin but he needs help to use that insulin more effectively. While on Pred he the persistent increased in blood sugar may have made him become insulin resistant. Whether that will reverse I don’t know. People here have reversed their tendency to high blood sugar but it is an individual thing. How has he adjusted his diet?
After 14 years on pred I still have a very low Hba1c, Pred -induced diabetes is not the same as Type 2 since there is little wrong with your insulin sensitivity unless you continue with a normal carb diet and the whole shebang leads to Type 2 as Snazzy has explained.
You SAY you are leating very low carbs - but are you really? You also say you eat prunes before bed - there are 6 grams of carbohydrate in a single prune. Snazzy and I need to eat almost keto levels of carbs to lose weight though maintaining weight isn't as hard for me - that is 20g of carb, 4 prunes leaves nothing for any other carbs, Are you eating fruit? Many people bemoan their low carb diet is not doing what they want but then it turns out they are sncking on grapes and apples! Both are high carb options.
I was diagnosed type 2 after 3 months on prednisolone. I was put on gliclazide and cut my carbs drastically. At my 6 monthly review my hba1c had come down so taken off the gliclazide. I find low carb and walking helps keep my sugars down. I also notice from finger prick tests that my sugars rise midday so miss out on lunch.. my hba1c for the last 6 years has been under diabetic range, my last being 36. I still consider myself as type 2 diabetic in remission. My nurse considers my sugars are goid and I can eat more carbs because I am steroid ducted.
I was pre-diabetic for minimum 5 of the 7.5 yrs on prednisone. I was strict since day 1 as to next to no carbs but still managed to gain weight. When I got down to 2 mg my levels greatly improved and when I got off I have low sugar levels.
I know everyone if different but I went back to normal, just need to loose the weight.
I was diagnosed as pre diabetic whilst on prednisone but it disappeared when I got to under 5mg
I was prediabetic and overweight before steroids and am now diabetic. The Jardiance and Metformin are helping. I am losing weight on them. But… I am having a terrible time with carbs due to lots of travel with three square meals, sweets, white stuff and a bit of alcohol. Anyone who can manage blood sugar by diet alone is better disciplined than I have. And that’s a good thing!!
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