Since I had to increase pred because of resurgence of GCA in summer (up to 15 from 0.25 now on 9) I am using a continuous glucose monitor (CGM) for a couple of weeks.
The pred spike was very noticeable. I estimate it can start anywhere from 2 1/2 hours after eating and go on for around 7 hours. My post breakfast meal readings are Ok, as are evening meal when eating at 6.30. In the middle it can get wacky - the same food at lunch causes a far bigger spike than in the evening.
The last time I did CGM I was on 3mg and I didn't notice any spike. My friend who is on 5mg pred with a CGM for complex reasons says it is noticeable at 5mg.
For people who struggle with blood sugar there is definitely value in timing meals and treats.
Interested to hear what others have found. I think it may have been Snazzy ? who reported spikes around 4 hours after pred. Good wishes, all. X
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Viveka
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As you say - perhaps a standard pattern! It does make me wonder a bit whether it is something they should do a study on so they can be a bit more proactive in guidance on diet and how it can be adjusted best when on pred to reduce the risks of steroid induced diabetes. The fact that you can't just say "don't eat" but time of eating is significant makes it all the more interesting I think.
Yes, I think this would be very helpful info for people. Massive salad (9 ingredients including kimchi) with egg, cheese or houmous. Add a slice of organic wholemeal and it goes up a mmol so I think I'll cut that out for now. The thing I most noticed was that a slice of homemade pizza at night was 2 mmols less than at lunch time.
Probably a not inconsiderable amount of carb in that salad depending on what you put in it. Wholemeal or not - at least 12g carbs in that slice of bread, another 7 in 50g hummus. But the timing thing is really interesting.
I don't usually eat until lunchtime or often much later - just lots of cups of tea having effectively taken my pred at 2am (Lodotra) and it isn't a problem having done it for years.
Without the bread, it goes up within normal parameters; with the bread a bit over. It's the full-on carby meals in the pred-glucose zone that cause the big spikes.
I'm thinking that in the zone, baseline goes up overall by one or two mmols.
yes, I noticed when I took my pred at 8 a.m. with breakfast my spike started around 12 noon and lasted until about 6 pm. For this reason I eat my breakfast and then don’t eat my next meal until 6.30 p.m.
I found this out by testing a lot with my glucose monitor. I have also discovered that now at 3.5mg of prednisolone my spikes are not nearly so high. I have my hba1c blood test tomorrow so will be interested in the results. Hopefully I will still be in remission
So this definitely looks like the pattern. I commend your willpower not eating during the day!
Let us know how your hba1c goes. Did you use Freestyle Libre, btw? Did you come to any conclusion about how close, or not, its hba1c estimate is to a blood test?
No I know that - but I wondered if a no carb meal would work too. Some people struggle with TRE (time restricted eating) although a smallish study did find that it improves blood sugar control in T2 diabetics - so increasing evidence it has its place.
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