raised HbA1c

[Temeraire]

I told my GP I hadn’t had any bloods done for well over a year when I went regarding a skin problem. She only ordered FBC and HbA1c. Unfortunately no ESR or U&E’s. I’m a bit upset as HbA1c gone up to 50 which puts me in diabetic realm. I try to keep carbs low but ‘could do better’. Just had message that GP phoning me thursday evening to discuss result. Bet they want to start metformin but we’ll see. Currently tapering to 5.5mg Pred. Guess I’m going to have to be a lot stricter! Don’t know if I should accept medication or just try being strict with carbs. I don’t eat ultra processed food but have a feeling low carbs will be harder! Oh well…just have to get used to it I guess.

[SnazzyD]

personally I would go for doing it myself as plan A because medications are not a tailor made fix, they are an attempt to get your metabolism to do the right thing. There might be side effects, of course. Some would argue that low carb diet side effect is misery. It may not be as easy as popping a pill and eating more what you like either. It may well be that actually you are eating a lot more carbs than you think and so cutbacks are not too hard to achieve. Some may say that is a desperate attempt to make it sound appealing as an option. It might be that you need to do both in the end. Have you discussed it with them yet?

[Temeraire in reply to SnazzyD]

Not yet - GP phoning me Thursday evening. I would rather do it myself and certainly wouldn’t take a pill and be careless with diet - that way lies disaster I think. I’ll see what they say but I know I have to cut the carbs more thoroughly. I’ve been checking blood sugar (finger prick test). Its normal first thing but goes up by midday - especially if I have any carb at all midday it seems.

[piglette]

Reducing weight is one of the best ways to fight type 2 diabetes. Dr Michael Mosley says he managed to drop to a normal reading by losing weight.

[Temeraire in reply to piglette]

Thanks. I’m going to try. Aiming for between 10lb and a stone. 🤞🏻

[autumnlass in reply to piglette]

A wonderful man who we all miss very much. 😢

[Temeraire in reply to autumnlass]

Yes indeed. Still can’t believe what happened to him. Such a shame.

[Gimme in reply to piglette]

I was going to say the same thing as Piglette. Assuming that you are overweight in the first place. Not easy on pred, but it is doable, and I found that avoiding any foods and drinks that have added sugar was the best way to control the pred munchies and hunger.

[HeronNS]

I have tended to run high blood sugar while on pred, and it was only down to a level where the doctor was happy when I was eating hardly any grain or white potatoes at all. I did eat other root vegetables and a small amount of rice (I'm thin and need calories) but no sweets. Filled up on salads packed with nourishing veggies which needed a lot of chewing, and as a vegetarian (not vegan) I got most of my protein from nuts, seeds and dairy.

Because our microbiome appears to have a lot to say about what foods we crave it can be best to go cold turkey and just give up all "white" carbs for several weeks and see how you get on. That first winter, after being so abstemious for several months, I found myself actually craving leafy greens! Not sweet treats or baked goods. I believe this shows that the gut microbiome had adjusted and adapted and now preferred the healthier foods, and therefore so did my conscious brain!

[Temeraire in reply to HeronNS]

Thats very interesting. Think I’ll give it a try. I do love carbs so it is encouraging that craving will stop. Thanks

[HeronNS in reply to Temeraire]

🍀

I think there's a theory that our microbiome functions as a sort of secondary brain, therefore it's not beyond possibility that it can affect our behaviour. What I like about the theory is it gives us some way to influence our own behaviour towards a desired outcome without having to rely, often painfully, on willpower alone. That's why the cold turkey approach is best until the good new habits are established, because that's going to be how the microbe population gets rebalanced.

[Temeraire in reply to HeronNS]

I’ve heard lots about gut microbiome. I think we are only beginning to understand its importance. What you say makes sense. I’m hopeful it will work. Thanks

[HeronNS in reply to Temeraire]

Hope it does. For me it was an unexpected turn of events but when I thought about it it made sense. I'd only stopped eating what I discovered, when examining my diet, was a lot of wheat in various forms in order to keep the blood sugar in check. Didn't really think about microbiome then, but now I know more about it. Wish doctors did too!

[Temeraire in reply to HeronNS]

Yes me too. One day maybe….

[Abcd123455]

I was in pre diabetic range last year on 8 mg from memory. Opted for a diabetes prevention group run by a dietician and did lots of food switches like brown rice, brown pasta, portion control ( not always!) and between tapering down the pred, losing a few pounds and eating a bit better my latest results are normal again. Hope you have the option but the effects of non controlled diabetes over a long period are not great so you’ll have to weigh it up. All the best.

[Temeraire in reply to Abcd123455]

Thank you. Thats encouraging.

[Pixix]

I reversed mine with two months on the Keto diet, yiu may want to look into it. This subject comes up quite frequently, as this happens to many of us, so you should be able to search, check FAQs, & find more info on this site.

[Koalajane]

I was diagnosed type 2 and put on gliclazide. I cut my carbs drastically and at my first review was taken off the gliclazide as my numbers were in the normal range. They have stayed around 38 for the last 7 years and I really don’t struggle to eat low carb. I test regularly and have noticed I am not getting such big spikes now I am on 3.5mg of pred. Looking forward to my next diabetic review. Oh and I walk over 10,000 steps each day, ending with my last walk after my evening meal.

Good luck

[Temeraire in reply to Koalajane]

Wow I’m impressed by that (and encoraged) Thank you

[Mewy]

I also had raised A1C after prednisone gained 20lbs during bout with polymyalgia and taking Pred. I seriously craved carbs and tried but did not succeed in limiting them. After coming off PRED when my doctor told me I was predabetic I limited carbs, monitored my food intake and was able to return to my earlier weight with my A1C in the normal range. I hope this encourages you to know that you are not alone and that you can return to your blood results pre-PRED. Mewy

[Temeraire in reply to Mewy]

Thank you. It is encouraging to hear it can be reversed.

[winfong]

I too have steroid-induced diabetes. I tried to control it with diet and exercise, but finally had to go with meds. I tried methotrexate and Rinvoq, but neither worked that great. Ended up with Januvia, which is terrific - great results and no side effects.

Do be careful, though, if you do decide to go with no meds. My dad did that and ended up losing a leg.

[PMRpro Ambassador in reply to winfong]

Metformin surely, not methotrexate??

[winfong in reply to PMRpro]

Oops - yes

[autumnlass in reply to winfong]

🥺Poor Dad - I’m sorry.

[Temeraire in reply to winfong]

Oh dear. Thanks for the info. I will be careful and do whats needed.

[Sufferinginsilence]

I too, had raised HBA1C after a routine check-up, also down to 5.5mg steroids but have been tapering for years! I was referred to the pre-diabetic course by my GP and although I am still in the prediabetic range, my blood results have improved and I have lost almost a stone through following their recommendations. When I started the course, I was barely doing 2500 steps a day and now I am regularly doing 10,000+. They emphasise the importance of exercise more than diet though - the course is quite long and I am hoping to be out of the prediabetic range when it ends in October. It might be worth a try?

[Temeraire in reply to Sufferinginsilence]

Yes it sounds good. I will take it up if I’m offered. Well done. Hope you get good result in October.

[Mfaepink1973]

It sounds like you really need to cut out all bread, cakes, biscuits, pasta and potatoes for a month or so which should bring your weight and blood sugar down. Once you’ve done that you could add back a FEW carbs and see what effect they have on your blood sugar. I recommend getting a free 15 day trial of a continuous glucose monitor, I got a Freestyle Libre 2. You’ll find it’s surprising what effect various foods have on blood sugar levels and I now know pasta is a definite no go for me but a scone with jam and cream hardly had any effect 😋 (That doesn’t mean you can go ahead and eat them, we all react differently!)

Best wishes whatever you decide to do

Pauline

[Temeraire in reply to Mfaepink1973]

Yes thank you. Thats my plan. I’ve got a finger prick glucometer and discovered my blood sugar is normal when I wake up but goes up sharply at lunchtime if I eat any carb. Not so bad in evening but still goes up if I eat carbs. Very interesting that different foods affect us all differently. I’ll look into that libra monitor. Thanks.