PMR, Prednisolone and diet

[LittleJane]

I have read a bit about the effect of Prednisolone on bone density and also on blood sugar. Can anyone give me a heads up on this as I have a family history of type 2 diabetes in later life and I have osteopenia (Dexa scan every 2-3 years)

[PMRpro Ambassador]

Some people have found that cutting carbs drastically does allow them to manage their blood sugar levels better - Koalajane in particular and she will probably reply to you. I have been on pred for over 15 years, a lot of it at well above 10mg and my Hba1c has remained in normal range with no sign of even pre-diabetes.

Almost all of us have osteopenia, it goes with the age so what is most interesting is the degree, Is it almost normal or almost osteoporosis? There was an excellent talk at this year's AGM which was recorded and is now available. Normally you need to be a member of the charity to get the link from Fran_Benson , one of our admins but if you contact her she will give you details,

However - the message was that it is best to start some form of bone protection sooner rather than later to reduce the risk of pred-related damage to your bones. They don't prevent you developing fractures but they do approximately halve that risk although it isn't an immediate effect and with tablets can take several months to establish.

I didn't take a bisphosphonate until this year - my dexascan result stayed in a range where normally just calcium and vit D are recommended and that was all I did. A spinal x-ray about Christmas time showed a possible compression fracture and I agreed to start a course of 3 infusions, three at yearly intervals, just in case. I felt as if I had flu - common with the first I'm told, usually lasts a few days, for me it was nearer 3 weeks! It also triggered some arrythmia episodes but that isn't too much of a problem with medication I was already on, I've had atrial fibrillation as long as I have had PMR and had recently had an ablation, this is a different type of arrythmia. But I will have the next infusion - spinal fractures would be far worse although this one didn't seem to have caused pain but I have back muscle problems anyway so it is difficult to tell.

[LittleJane in reply to PMRpro]

Thank you so much for sharing. I will speak to my endocrinologist who orders my DEXAs and see what he says.

[DorsetLady PMRGCAuk volunteer]

PMRpro replied… but there is loads of info on bone health in the FAQs - and the ROSn- has much more info and videos on same -

theros.org.uk

[LittleJane]

Thank you (off to find the FAQs)

[PMRpro Ambassador in reply to LittleJane]

Link at the top of every thread, in a box under the post

[DorsetLady PMRGCAuk volunteer]

Easy peasy once you get the hang of them - and good to know your way around them….

[Koalajane]

hi, just a quick word about type 2 diabetes.

There is such a thing called steroid induced diabetes which is what I think you are worried about because the steroids spike your sugars. My hba1c was high and I was put on gliclazide. I cut my carbs drastically and walked as much as I could and at my first review about 6 months later was taken off the gliclazide as my hba1c was low (about 36 where pre diabetes is 42 to 47 and diabetic is 48 and over). That was over 6 years ago and I have kept my sugars down so stayed out of the diabetic range. I still get the diabetic checks every year as once a diabetic always a diabetic.

Sorry for going on a bit. I hope your doctor is testing your bloods for diabetes. Mine apologised because she had not done so.

Best wishes from one Jane to another

[LittleJane in reply to Koalajane]

Thank you, I will add blood sugar testing to my notes to take to the doctor when I have my meds review after my holiday.

[HeronNS]

If you don't have osteoporosis (or even if you did because the info is still relevant and possibly useful to you) have a look at my story:

healthunlocked.com/pmrgcauk...

And this is interesting:

osteoporosis.ca/medical-con...

My blood sugar has tended to run high, to just the point below where they need to do something. Severely cutting "white" carbs (sugar, grains especially wheat) has been helpful.