Diabetes concern

[Blodders2]

Hi all. Diagnosed in June with PMR started prednisolone 15mg usual taper plan but I am not feeling good at all, after three weeks tapered to 12.5 felt awful after a week told by gp to increase back to 15 still not improving then told by gp to increase to 20, no great improvement but stayed on 20 for a couple of weeks then started tapering again, I am now on 15mg doctor has suggested a slower tapering plan 15mg for 4 weeks then taper down 1mg until 10mg then 1mg every four to six weeks, I am still waiting for that hallelujah feeling, I am so tired all the time, pain has gone from my shoulder but hips, groin are sore, legs ache so much, slight headache all the time, having trouble with my breathing, went to see my gp on Mon 1 Sept, she listened to my chest all clear, oxygen 98 so good, she said my last blood test for inflammation markers was raised so she prescribed me some antibiotics and sent me to have a chest xray as she said sometimes you can't always hear if their is an infection, she also prescribed me an inhaler and to top it all my HbA1c test taken Aug 29 is 48 it was 43 in May. I am feeling very miserable. Sorry chaps for moaning, but I know I will get some great input and advice from you all. Take care

[PMRpro Ambassador]

Not everyone gets the hallelujah feeling - but you should get relief from the pain and stiffness once you are on the right dose of pred. It doesn't sound to me as if you have. And in a patient with a known diagnosis of PMR, it isn't an infection that should spring to mind with raised markers but a flare of the PMR. Or, given the ongoing problems you describe, LVV or GCA being the problem.

Raised Hba1c - cut your carbs, drastically. Especially processed carbs, added sugar, root veg and fruit should be limited. A lot of people have arrested the rise in Hba1c simply by doing that. Pred changes the way your body processes carbs and triggers the liver to release sugar spikes from the body stores in liver and muscle. You can't control that but you can control the contribution from diet and that should help a lot.

[Blodders2 in reply to PMRpro]

Results back from XRay all clear as we thought it would be. Is having weak, aching legs, breathing problems, a headache, not temporal but all over another symptom of PMR. I have an appointment with my GP next Friday so will discuss if increase is necessary. Will take on your advice re diet. Thanks again for your brilliant advice.

[Fatsiajaponica]

Hi Blodders, seems to have been a lot of bobbing about with steroid levels looking at your history. I would listen to PMRPro on this and discuss with the GP. Perhaps you did not have long enough at the higher dose to clear out the built up inflammation before considering a reduction?

With regard to the diabetes risk on steroids, I am also very concerned about this and have embarked on a low carb diet (I take low as between 100 and 150 grms of carbs per day). I have lost a lot of weight as a bi product which for me is no bad thing atm. I also am eating healthier than I ever have and trust that this will also help my general health, my cholesterol has reduced so no statins. I eat berries with yoghurt and honey, no other fruit. I am waiting for a Hb1c test so hope It is working. Good luck with everything, sorry that you are feeling low, it's inevitable I think until you stabilise, which you will with your GP's support. Take care and let everyone know how you are doing.

[Blodders2 in reply to Fatsiajaponica]

Thank you for your advice. I have started to cut back on sugar intake, not easy, but I will get there. Hope your Hb1ctest comes back good. Take care.

[PMRpro Ambassador in reply to Blodders2]

It isn't just sugar - it is all forms of carbohydrate including fruit and veg.

[Fatsiajaponica in reply to Blodders2]

Just checked my blood results from 5th August, Hb1c test was 46!!! I didn't even see it. Many of the results were deranged and GP thought it was the high level of steroids, (I had been on 60mgs pred)he didn't mention the blood sugar levels. So, I have been on this strict low carb diet for 4 weeks plus, have another week before the next test so we will see if it has made a difference, fingers crossed, I'll let you know. I may have to follow PMRPro's routine and reduce carbs to 50gms, I'm mostly at 100gms.

[PMRpro Ambassador in reply to Fatsiajaponica]

Snazzy and I both needed even lower than that!!

[Fatsiajaponica in reply to PMRpro]

Oh gawd.....that will be a struggle but needs must....

[Blodders2 in reply to Fatsiajaponica]

Fingers crossed for good results.

[Blodders2 in reply to Blodders2]

Oh what a fun ride this PMR/GCA journey gives us. Keep Smiling 😀

[Koalajane]

as the others have said cut your carbs. My first hba1c result was over100 and I was put on gliclazide. By the time I had my next hba1c it was 36 and I was taken off gliclazide and have brain in remission from diabetes for over 6 years.

[Blodders2 in reply to Koalajane]

Wow that is amazing, how long did it take from your first test to get to 36hba1C. Thank you for replying.

[Koalajane in reply to Blodders2]

My second test was about 5 months after the first high test. I did cut my carbs drastically to about 50g but eat a few more carbs now!