I am a 62 year old male, who has been on Prednisone for two years now. I am currently on 6.5mg of Prednisone.
In the last week I suddenly had the following symptoms; blurred vision, extreme thirst, increased urination, feeling very tired.
My GP had me admitted to hospital on the back of high blood pressure, low sugar & high Ketos.
They have been running constant tests on me in the hospital (2nd day now), and they are now convinced I have diabetes.
What confuses me is that there is no sign of diabetes in my family, so where did it come from? I am not overweight, do not eat refined sugar, and have been off alcohol for 9 months now.
Is Prednisone the culprit.
Has anyone on this group become a diabetic, whils having no family history of it?
This is a totally new experience for me.
Can anyone give me advise on how my life is going to change and what to look out for?
Regards
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Ligaamisgefok
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Yes, prednisone can affect your metabolism. In my early days I had to cut out nearly all carbs (still ate root vegetables and small quantites of rice but no sweets, no bread, pasta, bowls of cereal etc). I'm still quite careful, although off pred for a few months now as I take glucosamine for osteoarthritis and this also can have an effect on blood sugar, although probably through a different mechanism than corticosteroids. There are other medications which can have an effect on the pancreas. And unfortunately post-2020 we have to bear in mind the disease which no one wants to mention which can affect any part of the body.
in my 12 years on this forum, I have heard many talk about contracting diabetes. In fact your blood sugars should have been checked regularly as it is a very common side effect of taking Pred.
I had over 10 years on Pred before finally succumbing to it. There is no diabetes in my family at all. The medication I am on controls my sugars well so far.
Thanks Suzy, I last had blood tests taken in May, and there was no elevated sugar level at that stage. Hence it was quite a shock to receive the diabetes diagnosis yesterday. The hospital has provided me with the glucose tester and the insulin Novopen to self medicate.
Did they say whether you have type 1 or type 2? If there has been damage for whatever reason to the pancreas then the dietary thing we go on about won't be sufficient for you. If they are starting you on insulin right away and you had those serious symptoms right out of the blue, after previously normal readings, that does seem more serious than pred-induced high blood sugar leading sometimes to actual type 2 diabetes, which can often (as in my case) be controlled by diet.
I was diagnosed with type 2 diabetes about 4 months after starting prednisolone. I was put on gliclazide and changed my diet. I cut my carb intake drastically and at my first review I had got my hba1c out of the diabetic range. I have stayed in remission for over 6 years as I still eat very carefully. It is the carbs that turn to sugar that raises the blood sugars. I found out by testing that my sugars when on above 10mg of pred could go into double figures without eating.
How did you cut your carb intake? Was it just reducing portion size, or cutting out certain carbs altogether? I have seen some discussion on measuring the carb intake, but am not sure how one goes about this.
I stopped eating potatoes, rice, pasta, cakes, I have 1 slice of wholemeal sourdough toast for breakfast. I eat veg grown above ground and eat berries rather than other fruit. I basically started reading the labels on food and I went keto for a while by eating less than 50g of carbs per day. It is recommended to eat more carbs than that and I do now have about 100g of carbs a day. I stopped snacking, eat raw nuts and lots of salads.
I bought a book carbs and cals pocket counter which showed me the carbs in things without labels.
You will receive specific dietary advice about how to coordinate your insulin dose with your meals, including what you should and shouldn't eat. Being newly diagnosed you would be best taking 'official' advice in the first instance.
Especially now insulin is in the picture. It becomes different case to having insulin production but the sugars going up because of the Pred effect on the liver making it produce more glucose and dietary intake adding more.
Suddenly becoming insulin dependent diabetic from scratch must have left you feeling shell shocked. There may not be many PMR folks on insulin since steroid induced diabetes is more commonly Type2 ie controled with diet or tabs. You should get a lot if input from the hospital and your GP Surgery to help you come to terms with it all.
Being on corticosteroids can result in increased blood sugar levels - and long term steroid patients should be monitored for that effect, with their Hba1c level being checked at least every 6 months, That is a reflection of average blood sugar levels over the previous 3 months and if it starts to creep up, then remedial action should be considered - above all we recommend cutting carbs drastically since steroid-induced diabetes is due to the steroids triggering the release of glucose from your body stores in liver and muscle and if you eat a lot of carbs the combination can make that average BS level creep up to the point where there is potential damage to organs and the rest of the body.
However - what you are describing sounds like a sudden onset and the fact they have immediately put you on insulin does suggest they have identified a lack of insulin as the problem. Once you have one autoimmune disorder, there is an increased risk that you can develop another and insulin-deficiency diabetes can be as the result of an autoimmune problem that damages the cells in the pancreas that produce insulin and you then need a replacement therapy.
In all the years I have been on the forum I can't remember there being anyone who that happened to - there are plenty who developed either steroid-induced or Type 2 diabetes which was managed either by diet or oral antihyperglycaemic medications such as metformin or gliclazide as the most common. Steroid induced diabetes almost always resolves as the pred dose falls. Type 2 can sometimes be reversed - Koalajane managed that with her strict keto diet. Research in the UK has found that Type 2 diabetes can be reversed with a shortish sharp shock of a low calorie diet (800 cals a day over a few months in the form of soups and shakes).
It very much depends on what has caused your diabetes and if it is damage within the pancreas, you are likely to be insulin dependent. That is up to the endocrinologists at the hospital to work out and explain to you. They will also teach you how to calculate your insulin requirement based on what you are about to eat/have eaten.
But it isn't the end of the world, millions of people live with it very well, including professional athletes. And I would say at this point - wait and see what they discover. It may be what is called LADA:
Thank you very much for the info. I am having to get a crash course in understanding and managing diabetes, and all this feedback helps. They still have not figured out what diabetes type I have, due to the high level of ketones in my body, but suspect Type 2.
Initially the hospital prescribed me Gliclazide; but on consultation with the diabetic nurse specialist, we agreed to go straight to the insulin to try get my BS under control as quickly as possible.
I will be following up with a visit to the diabetic clinic within a week, where they will reassess my condition and help me to manage it. At least now I will be forewarned with knowledge and will be able to ask the right questions.
On the meantime my wife and I are concentrating on changing my diet - portion sizes, carbs, etc.
As you can see from one of the links - if I remember rightly at least - it could be Type 2 that just wasn't evident over years and suddenly the pred tipped you over the edge. If so, it is possible to reverse it according to new studies, even if it has been present for a time. They thought initially that only newly diagnosed patients could be "turned round" but they are learning all the time, But a decent diet without cakes and biscuits and "snacks" can make a massive difference - it is persuading the average patient to give them up that is the problem usually together with their total lack of understanding of the implications of long term high blood sugar.
But the diabetes experts will guide you through the maze while you educate yourself about this new situation. Good luck with them - I hope they are up to date and empathetic.
I will not have an issue with cakes, sweets, etc. as I gave up refined sugar of my own accord 3 years ago. I am already learning the importance of managing my diet, especially the carbs. I am determined to beat this diabetes thing asap.
Hi, I got sudden onset of both PMR & GCA before Christmas after travelling from U.K. to US to visit family. Became very unwell indeed very quickly and had to go to ER. No diagnosis there but huge insurance bill😬 Eventually found a Dr who cared for me and started me on high dose Pred. Eventually got a consult with Rheumatologist who was great. Unfortunately the steroids put my previously very well controlled type 2 diabetes into hyperdrive and I was back in the ER in the New Year with steroid induced hyperglycaemia (another big bill for not much help!) I then had no choice other than they put me on insulin which came as a big shock only ever having taken one metformin a day for 17 years (type 2 is in the family and I have 2 siblings with it).
On returning to U.K. I was seen in the diabetic clinic and given the Libre sensor and insulin pens rather than the old school stuff I’d had to buy in the US. However I was given no dietary advice whatsoever and in my ignorance I focussed on the amount of sugars rather than carbs in my diet. Big mistake! It’s been a very tough 8 months but I’ve learned an awful lot. Mostly by myself and forums such as this and the marvellous charity PMR/GCAUK.
Not all medical support is equal. I’ll be honest and say my diabetic nurse has not been the best, she was happy to give me all the stuff but less helpful re guidance and advice despite this being my first ever experience with insulin.
I can’t believe how wrong I got the diet thing initially but then again I was coping with 70 mg of Pred with all its side effects after a double whammy of 2 scary and painful auto immune diseases I’d never even heard of!
I soon learned what foods I could have to help control my blood sugars, I think we all react differently to different foods. I actually really enjoy my new diet and feel much better for it! I lost weight I needed to lose and I don’t intend to go back to bad habits should I ever return to how I was before all this happened.
Read the labels carefully, look for carbs not just sugars….As you will have found, Pred makes you hungry all of the time so it’s not an easy path but one I’m sure you will navigate. I wish you the very best of luck and hope you have the right care and support.
There are many ways of dealing with this ..you may prefer not to follow the establishment narrative which insists that the only way forward is drugs drugs drugs in ever increasing quantities and strengths. Look out for Jason Fung and his book "The Diabetes Code" and also search for Dr Sarah Myhill and Dr Michael Moseley They all have different ,effective natural ways of sorting out diabetes...it's a question of deciding which is a good fit for you. It is possible to try out their methods alongside the mainstream but your meds will need fine tuning with regular tests. Be prepared for a lot of huffing and puffing if your regular medic is not attuned to alternative ideas. But they do work. Good luck-T2 is a scary diagnosis but if you can take it into your own hands, it needn't be.
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