I’m diabetic type 2 . I was put on a high dose of steroids in the spring , due to suspected GCA after being diagnosed with pmr . I was on the steroids for about 4 months . Rheumatologist tapered me off . Pain returned in neck , shoulders , arms, hips & upper legs. And as time has gone on the pain is agony. I have an appointment with rheumy in 2 weeks.
My concern is that my blood glucose is always high ! And I think the steroids caused it . My Gp told me off as my HCb 1a was far too high . I explained I’d been on steroids .
I am worried incase I end up type 1 diabetes!
And should I refuse steroids if doctors want me to take them ? Does anyone know how long after tapering , the blood sugars will go down ? If ever they will !
Written by
TedTheMaineCoon
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If you have PMR and/or GCA then steroids are the first choice and most successful drug - and if GCA it will protect your sight… and 4 months is not long enough -both last a lot longer.
Steroids can increase blood sugars - but there are a quite a few on here who seem to manage both their disease and their steroids. Hopefully they will along soon.
You won't turn from Type 2 to Type 1 unless the autoimmmune disorder takes it into its head to destroy your pancreas. The high blood sugars ARE doing damage to your body.
Steroid induced diabetes happens because the pred triggers your liver to release random spikes of glucose from the body stores in liver and muscle. You can't control that - so we suggest cutting carbs drastically to reduce the contribution THEY make to blood sugar levels. Koalajane managed to reverse her Type 2 diabetes by doing so. Some people need more metformin or whatever. There are several diabetics on the forum.
Why did the rheumy taper you off? PMR needs a lower dose of pred than GCA but it still needs some, Untreated PMR is thought to be more likely to progress to GCA and the unmanaged inflammation does cause damage to your body.
Hello, I found that my metabolism was still sensitive to dietary carbohydrate for some months after stopping Pred. Even now I need to be more careful than I was before Pred. Pred forces the liver to increase blood sugar even before you eat anything. The easy way to deal with this is consistently cutting carbs in your diet; have you tried this? . An honest food diary can often reveal more than you think is going in.
you have had a fairly chaotic time with diagnosis and steroid support. Did you ever have relief of any pain when on Pred?
Yes when on pred I was pain free . Thank you for your reply . Yes I’ve started to drastically reduce the carbs & writing down all food intake . Grateful for your information.
I've fallen into the pre-diabetic range since being on steroids but GP advised it would only become a concern if my blood sugar levels continue to rise which they haven't done yet. I've reduced consumption of potatoes/rice/pasta so not sure if this made any difference. Both conditions need simultaneous proper management. I would not leave than rheumatologist consulting room without a prescription for steroids and you stay on them for long as your body needs to heal
Type 1 and Type 2 Diabetes are two different conditions .Type 1 is an autoimmune condition usually with genetic links through the family. You can't get Type 1 Diabetes from having uncontrolled Type 2 Diabetes.
If you had Type 2 Diabetes before starting steroids the steroids can make the symptoms harder to control because steroids , like various medications, can increase your resistance to insulin and effect sugar balance and fat distribution.
This partially occurs because steroids can affect how well you absorb nutrients that help in the metabolism of sugars.
So should having Type 2 Diabetes and an increase in these symptoms put you off using steroids?
The simple answer is No.
If steroids are required to control another illness the benefits outweigh the risks.
Firstly, because uncontrolled inflammation can also increase your blood sugar and make it harder to control your Type 2 Diabetes.
Secondly, because your type 2 Diabetes medications can be adjusted to help reduce the affect steroids have on your blood sugar , and various diet and lifestyle approaches can be used to improve Type 2 Diabetes even when you are taking the steroids.
While on steroids , a way to prevent Prediabetes , Type 2 Diabetes or to manage the condition is to do the following:
Only have processed sugar for very occasional treats.
Increase your water intake , especially at meal times.
Avoid artificial sweeteners
Don't eat premade processed meals or certain deli meats and look for hidden sugars in savoury foods this includes allegedly healthy and vegan snacks which often include a lot of sugar , palm oil and coconut fats
Eat a wide variety of vegetables and fruit and increase protein in the diet to improve your nutrient levels and help to prevent spikes in blood sugar.
Increase your intake of foods containing Vitamin B 12 and Folates .
Eat a variety of nuts and seeds but limit sesame as this can increase blood glucose levels.
Choose fat options which are high in good cholesterol and avoid foods with saturated and trans fats and bad cholesterols.
Reduce your carbohydrates to a healthier sized portion with your meals and low carb snacks and choose carbohydrates wisely by steering clear of the lower quality " white" carbs and choosing better quality carbs with a low G.I , like skin on potatoes, multi seed and whole grains. Oats , beans and pulses , brown or wild rice. fibrous fruit and berries.
A healthy amount of carbs in your diet depends on whether you are on a weight loss programme or restricting carbs because of medication, your gender and age , and how physically active your average day is. Generally speaking this is different for non diabetics and people with any type of Diabetes.
Diabetes guidelines recommend 10-45g per meal for women on average( based on 3-4 meals a day ) and 15-50g per meal for Men on average ( based on 4-5 meals) upto 130g a day for Type 2 diabetic women and higher for very physically active people and athletes. The lower recommended figures are for those diabetic people on a low carbohydrate diet for weight loss who are less active.
It's not generally considered healthy for any type of diabetic to eat the very low levels of carbs seen on a Keto , Paleo or strict LC/ HF diet even during weight loss. The least carbs recommended for diabetics on a short term restrictive weight loss plan 50 g + a day.
Try to remain active each day , even if it is just a ten minute stroll before or after meals and some gentle stretching. A little regular movement through the day helps your blood sugar and prevents stiffness and Fatigue.
Your blood sugars can remain pretty much the same when you begin steroids or can come back into normal range for someone with long term Type 2 Diabetes if you follow these guidelines whilst you are on steroid treatments.
Type 2 Diabetes or Prediabetes can be reversed after stopping steroids if the steroids were the cause of these health issues by continuing to follow the diet and activity guidelines suggested to prevent these problems becoming severe whilst taking medication, but , it can take a year or more depending on other health issues , other medications, BMI, and how these effect your diet and mobility.
If you had Type 2 Diabetes prior to PMR or steroid/ drug use you are more likely to get an increase in glucose levels after starting Pred and you will need to be more careful about following dietary guidelines and get regular checks with the GP to adjust the dose if your Diabetes medication if you need to.
I have just purchased the tom kerridge book The Dopamine Diet. All low carb and the recipes are delicious. I am not sure I can be completely without carbs but it is lovely to have tasty low car recipes.
The recipes are nice but the diet would also be classed as moderately low carb as you can eat upto 90g carbs a day on the regime which puts it in the healthier parameters of low carb diets . The combination of ingredients seems to be the key promoting brain foods.
Ted, are you on medication for your type 2 and if so what is it? Was your diabetes well controlled before going on steroids.
I got diagnosed type 2 about 4 months after starting on steroids. I was put on gliclazide and at my first review my hba1c had come down to 39. This was because I cut my carbs drastically and started walking more. I was taken off diabetic meds. I have been in remission since then with my hba1c averaging 37.
I have 1 slice of toast for breakfast with a scraping of peanut butter, no lunch because that is when my sugars are spiked by the steroids and my evening meal is also low carb, often a salad with avocado, eggs, cheese, salmon or chicken. Sometimes I will have an omelette or a stir fry.
Hopefully you have been told to read labels to check how many carbs are in foods. Carbs turn to sugars. The only fruits I eat are berries, I love blueberries and strawberries and eat them with full fat Greek yogurt. If you do eat yogurt full fat is best because they add all sorts of things to low fat yogurt.
I think you need to talk to your doctor or diabetic nurse for assistance.
Good luck to you and please message if you need help.
My surgery is very good and encouraged the low carb, healthy fat diet. My diabetic nurse is also quite knowledgeable about PMR and even said to me at one review, that the doctor had said my ESR was okay but I can see it is higher than usual for you, she looked at me and said “ you are hurting aren’t you?” Bless her
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