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.

[Fatsiajaponica in reply to PMRpro]

Generally better though if keeping them at 100gms or below? Also what are your views on the HI-Lo carb bread - 5mgs carbs per slice? I've been using this to move below 100gms.

[PMRpro Ambassador in reply to Fatsiajaponica]

Like Snazzy I aimed for much much lower - we had to to manage weight.

Actually, I've never heard of the bread you mention. I don't bother about bread - UK bread isn't worth it IMHO and if I started on bread here, I'd soon hit 100 from bread alone it is so good! I get a small loaf of really good stuff, slice it and freeze it and it is a special treat, On my way back from the UK my German friend gave me nearly half a loaf of superb dark rye, when I got home I halved the slices and froze the lot. Half is still in the freezer after 3 weeks. I'd rather have a bowl of salad leaves, tomato and cucumber with a bit of bacon on top than a BLT,

The trouble is, being on pred moves all the goalposts and while 100g of carbs is low compared with the average diet, it will still add to any spikes of blood sugar and in this case, especially when you have this window of spiking levels due to pred. Timing has a big place to play,

[Poshdog in reply to PMRpro]

You need to visit my Baker!!!

[PMRpro Ambassador in reply to Poshdog]

Who and where?

[Poshdog in reply to PMRpro]

Thursday market, Bradford on Avon!

[PMRpro Ambassador in reply to Poshdog]

Used to be a brilliant stall in Cambridge market - 30 years or so ago!!! Real German rye!!

[Polygolfer]

I would suggest you see your GP.

[Motida in reply to Polygolfer]

Thank you very much everyone for your information and advice. I will try and get an appointment once I have got a handle on what I have to do to get a better reading. For instance I did not know that Pred causes spikes at times and I expect that will be news to the GP as well. Basically I am not keen to have another medication prescribed. If I refuse something it will go on my records which does not look good. On the other hand at 81 who bothers?

Thank you again.

[PMRpro Ambassador in reply to Motida]

It shouldn't be news to the GP - though whether they know exactly what pattern it can take is another matter. But you are pre-diabetic not diabetic and changing what and how you eat it should result in a lower Hba1c without more medication.

[Viveka in reply to Motida]

You'll have seen my post in today's bulletin, and the helpful replies from people who are managing this problem. Click on my name and you will get to my original post about reversing prediabetes - which is perfectly possible and several on the forum have done it. Look at what ZOE had to say and the much missed Michael Mosley - it was one of his 'big things'. I think many of us were bubbling under prediabetic even before pred so we cant rely on tapering taking us out of danger and we need to take action. Diet and lifestyle are the first port of call before meds, unless there are particular risk factors involved.

[Bcol]

I can't add to the advice already given and just wonder why the reluctance to see your doctor. A face to face appointment, armed with all the relevant information from here, to discuss it all sounds a very sensible way forward.

[Pixix]

Yes, happened to me…first time I reversed it after two months on the keto diet…now I’m back in trouble again & the surgery have signed me up for a course about diabetes & nutrition etc. I’m due another test as soon as I make the appointment. But I’m now ‘labelled’ as pre-diabetic at doctors & they keep nagging me about it! Guess it’s the keto diet again….

[Polygolfer]

Dear Motida, Steroids affect people in different ways… depends on your health history, current illnesses, medications you are taking and what you are naturally predisposed to. Even on lower doses than most, I had poor sleep, sugar levels were raised (this is dangerous as if not controlled CAN lead to Diabetes), mood swings, irregular heart beats etc. Others can live with steroids seemingly unscathed but there are side effects that are more long term that may not be immediately detected. So, as many have recommended, best is to see what the GP has to say/offer and perhaps, if you are still unhappy, seek a second opinion (from a doctor).