Does Pred. cause Diabetes 2?

[Motida]

My blood test of 30 Sept 2024 shows a glucose reading of 45 in a range of 42-47 as prediabetic.

My GP has flagged up to be discussed at next appointment. I wondered if taking Pred for 2 years and now down to 7.5 mg has any bearing on this reading before I contact the GP?

The reading was 41 in the July test. I have read a bit in the web page for Diabetes and got the drift - lose weight, no sugar and so on. Losing weight through exercise is not that easy with PMR and neuropathy in both feet, but I do try and walk when I can.

I was at a party at the weekend with lots of cakes and no-no foods and wondered if I could blame that for this high reading last Monday or does it take longer to show up?

In short if I can get advice about the Pred and reducing the prediabetic threat so I dont have to see the GP, that would be great. I gained 10 kg at first and have now lost 5 Kg of that (70kg now).

Thanks for any information or tips.

[DorsetLady PMRGCAuk volunteer]

If you read your patient information leaflet for Pred - it lists this as a common side effect -

• increased blood sugar

For most most people it usually reduces as you lower the Pred dose... but your recent increased reading may or may not be due to too much sugar the previous weekend... I'd suggest another test to see if it has reduced on it’s own.....

and fingers crossed it has ..😊

[PMRpro Ambassador]

Pred doesn't necessarily cause Type 2 diabetes but it does cause steroid-induced diabetes. Type 2 diabetes is caused by problems with insulin - either your pancreas can't produce enough for your body (less body needs less insulin in that case which is why they say to lose weight) or your body has become resistant to the insulin activity.

Pred induced diabetes is caused by pred making your liver release random spikes of blood sugar from the body stores in liver and muscle. This means your average blood sugar level is pushed higher and the blood test they did rises. It is called the Hba1c test and reflects the average BS level over the last 3 months - so no, I'm afraid you can't lay all the blame on that party!!! When did the GP last check that blood test? Have they looked at it before?

Lots of people on the forum have been able to reduce their Hba1c level by cutting carbs a lot, especially processed carbs, added sugar and being careful to limit root veg and some fruits - lots of carbs in bananas and apples etc!

[piglette]

When I started on pred I really cut down on carbs and also I went gluten free. I became a total bore about food in fact. I went gluten free as I heard it would stop me getting a fat face!! My glucose readings tend to be between 37 and 38.

[PMRrunner]

I've had PMR and have been on prednisolone for the over 6 years, for the last 3 years under 5mg. My Hba1c reading in August was 44 so I have been referred to the NHS diabetes prevention programme. My previous Hba1c test was 36 but that was over 3 years ago so it might have been rising for a while. I've been lucky in my PMR journey as I haven't gained any weight, I probably weigh less than I did 6 years ago and have been mostly able to keep active. The diabetes prevention programme is very much based on losing weight and becoming more active, neither of which are really applicable to me but there is lots of information available to help you make better choices about food especially carbohydrates. I'm hoping that the changes I make to my diet will eventually lower my Hba1c levels

[Fatsiajaponica]

Well snap Motida, my BS was 45 on my HBA1C test on 8th August.. Since then, and just before, I have been low carb (100gms daily) no cakes, sugar etc...only complex carbs. Also the algorithm has invited me to a pre-diabetic course. I think I am doing most of the right things so will give it a miss unless the next test is as high. I have a phone call coming from the GP next week and will request another test at the 3 month mark. I think it is the pred but I'm still on 20mgs. We can compare notes. Good luck.

[PMRpro Ambassador in reply to Fatsiajaponica]

While complex carbs work for non-pred patients, they don;t work in the same way for us. Any carb will top up the pred spikes.