blood sugar rising

[lsplumb]

I've been on prednisone for nine months and am down to 6 mg currently. Last time I had my A1c checked it was 5.8%. With my check yesterday it was up to 6%. Although still prediabetic, I was hoping to hold at the 5.8% as I have cut back on carbs (but not to keto level).

My question: at what point in the prednisone journey does it quit messing with your blood sugar? Do you have to get to near zero prednisone for blood sugar to stabilize and/or go down? I'm guessing I have at least 9 more months of tapering on prednisone if all goes well, so this blood sugar business is starting to worry me. As an aside, my naturopath recommended taking the supplement berberine which is supposed to help lower blood sugar. But it also apparently thins the blood, and I'm already on a blood thinner for blood clots, so probably can't take that any longer. Appreciate hearing about your experiences.

[piglette]

With a smaller amount of pred, the effect is reduced. A good diet is the best way to combat the increase rather than taking supplements suggested. A good diet is also a good idea for us all if we have PMR or not.

[SnazzyD]

Have you tried a food and drink diary for a few weeks? Yes, keto probably isn’t a long term ideal but it is very easy for those carbs to rack up on the quiet especially through drinks.

I had to cut carbs very hard on high doses of Pred and pretty strictly under 20mg. I did find that after zero Pred I have had to watch carbs more than I ever did before Pred.

[PMRpro Ambassador]

It does improve as the dose falls but there is no specific point where it stops. For some people they have to get close to keto and many find there is a window for a few hours after taking their pred dose where the spikes of BS are particularly bad - some even don't eat at all in that period to gain better control of the Hba1c, Koalajane has written quite a few replies on the matter.

An Hba1c of 6% is 42 mmol/mol which is the measure we are more familiar with. 42 is a pretty good level but obviously you'd like it lower.

As Snazzy suggests, an honest food diary, including drinks, and weighing portions to calculate accurate carb intake can often be a revelation! All it needs is a larger portion or a bigger banana or apple than you think and your carb intake shoots up! And if that happens during this window I mentioned, you may get into trouble!

[Viveka]

If you click on my name you will find an interesting strand that suggests that, if you take pred at 8am, from around 10.30 to 6 is the time when you are most likely to get raised glucose which also spikes with food. So that is the time to go ultra-low carb. Also perhaps this effect reduces considerably once in single figures but is still active at 5mg but by 2mg not perceptible. Not scientific but worth thinking about.

[Pixix]

I’m down to 2mg & mine has got worse since tapering from 5mg. They are chasing me for my next blood test, but I didn’t want it near my birthday (coffee & walnut cake & some chocolates!) but I will have to get it done this week. They have referred me to go on a prediabetes course. However, I’m quite sick right now, first time I’ve had polymyalgia & fibromyalgia flare ups at same time, & worsening osteoarthritis & bursitis, & a course is the last thing I feel like right now!! Of course, if my result is worse than last time, then I will do it.

[Koalajane in reply to Pixix]

I hope your next test is better. Unfortunately your birthday treat will be included in your test result as hba1c covers an average over the previous 3 months

[Pixix in reply to Koalajane]

Oh, I realise that, don’t worry! The previous two weeks we were in France eating delicious gateaux…I’m sunk! Going to try & negotiate to try six weeks onthe Keto diet at same time as I reduce the pred to 1mg (halving what I take now)!

[Koalajane in reply to Pixix]

My last blood test was due just before we went to Ireland with our daughter and her partner. I thought great I can eat anything and a week before it was due the surgery rang to change it to the day after we got back! Yikes. Fortunately I managed and my hba1c was good.

[Pixix in reply to Koalajane]

Ha ha, that’s truly rotten!!

[SomersetJB]

Alongside watching what you eat and the carbs I would really encourage you to be more active if this is possible. I’m currently on 60 mg pred and about to have either MTX or Tocilizumab added to get on top of my GCA. My latest HbA1C is teetering on the edge of diabetes and so my daughter ( an endocrinologist) encouraged me to use a real time blood glucose monitor (the kind that sticks into your upper arm) for 2 weeks so that I could understand what’s happening better. One hour after lunch and my evening meal I have seen my blood glucose levels soar above 10mmol/L if I have more than 50g of carb. Amazingly I am able to rapidly bring them down with either 5- 10 minutes of strength based exercises or a 20- 30 minute walk. These really help me to head off the big spikes. Are you fit enough to increase your activity levels? Good luck !