An easy-to-read guide to lowering blood sugar levels and risk of diabetes - especially useful for us on steroids

[tangocharlie]

Useful for those who've been told they are in the pre-diabetes or even diabetes range or worried about weight gain and/or raised blood sugar levels due to steroids. Although technically what we get is steroid-induced diabetes the principles of prevention and managing it are the same as Type 2 diabetes, but with the added complication of steroids also increasing blood sugars (aka glucose) as well as food.

restless.co.uk/health/healt...

NB For further reading I personally think diabetes.co.uk is a more useful website with more detailed technical info than diabetes.org.uk

[Seekingasolution]

Thanks TC ! This and the 10 hacks you published provide great insight. I was stuck for what to have for breakfast if I couldn’t have sourdough toast, porridge with a sweetener, an apple or banana on my dog walks … anyway today, Day 1, I started with plain Greek yoghurt and walnuts . Cheesey omelette and salad coming up later !

[tangocharlie in reply to Seekingasolution]

I was just responding to you in another post when that email arrived in my inbox which was timely as there will be many in your position, being told they have high blood sugars but not knowing what to do about it. I was in that position but was convinced diabetes meds I was offered were not the answer, and I was right. Keep going with your changes and you will see the changes

[ethanrocks122 in reply to tangocharlie]

Thanks for sharing this. I completely understand how overwhelming it can be to be told you have high blood sugar but not know what steps to take next. I was in that exact position, and I also felt that the diabetes medications I was offered weren’t the right solution. I trusted my instincts and made changes, and I can confidently say that sticking with those changes has made a big difference. Keep pushing forward with the adjustments you’re making – you’ll definitely see the positive results!

[tangocharlie in reply to Seekingasolution]

PS You probably can have the odd apple, generally apples pears and berries (blueberries raspberries etc) are the lowest sugar fruit and OK in moderation. Sugar-free yoghurt or cream would possibly lower the glycaemic load as would nuts

[PMRpro Ambassador in reply to Seekingasolution]

Have I given you this link? Brilliant for learning the basics and the photos make it easier to see what's good and less good!

dietdoctor.com/low-carb

[Sophiestree in reply to PMRpro]

I've just been reading this as breakfast is a pain as there is nothing I fancy so am going to try a couple of these. Sometimes I just take my pred with Tims Greek Kefir yoghurt (which is fab) and then have lunch later if I really can't decide. How many eggs can you eat in a week though!

[PMRpro Ambassador in reply to Sophiestree]

Quite a lot probably!!! They have been rehabilitated after the lies about cholesterol ...

[Seekingasolution in reply to Sophiestree]

I’m with you there ! And I always liked my poached egg on a nice slice of wholewheat toast or eggy toasty soldiers !! Guests this weekend so I’m thinking scrambled eggs, smoked salmon and avocado!

[PMRpro Ambassador in reply to Seekingasolution]

I'll be right round!! Got a couple of avocados in offer yesterday - MIGHT be fit to eat by Christmas but won't hold my breath!!

Boil several at once, shell and keep in the fridge. I have an electric egg boiler for the hot variety - absolutely no problem, come out at the hardness you chose! Cut crudites of carrot, radish and cucumber, box in the fridge. Cream cheese in tubs. Portions of smoked salmon in the freezer. Bacon and eggs in the airfryer are brilliant too.

[Seekingasolution in reply to PMRpro]

Excellent ideas. ( thinks : get automatic egg boiler ! )

[Seekingasolution in reply to PMRpro]

Thank you. Very useful. I used to just run out of the door with the dog and grab about 3 medjool dates and an apple. Have sourdough toast , blood orange marmalade and coffee on my return. Yum yum ! Having to rethink or change a habit is a bit tiresome ! I don’t really want to cook an egg etc. But needs must !

[tangocharlie in reply to Seekingasolution]

My stand-bys if I desperately need a snack are nuts, a Baby bel or lump of cheese, slices or chunks of cold meats or a slice of cold frittata, If out and need to buy something to eat a high protein salad with things like tuna, quinoa and edamame or a last resort half a scotch egg or chicken on a skewer. I'm allergic to hummous so sadly can't have it but that would be good with some crudites. Whatever you do avoid pasta salads, bread/sandwiches, samosas, quiche, pasties, pies etc especially around lunchtime

[tangocharlie in reply to Seekingasolution]

Other stand-bys readily available in emergency include olives, wrapped mini-cheeses, lentil crisps or poppadums, pepperami (I mean in emergency as it is ultra processed crap really), mini peppers stuffed with cream cheese and other things in the M&S (other supermarkets are available) tapas range such as pickled curried cauliflower, cooked prawns. Lidl also does a range of pressed fruit low-carb protein bars handy to have in your pocket. A good rule of thumb I've found is to aim for between 20 and 50g of carbs a day, around 80+ protein and 30g of fibre

[Seekingasolution in reply to tangocharlie]

All good ideas there. I must admit after that advert for pepperoni which announced ‘Its a bit of an animal..!’ I was never able to eat it again ! I’m very partial to lumps of cheese and handfuls of walnuts. I used to limit these due to their calorific value but I’m having to rethink what I thought was good nutrition. I make my own hummus often enough with white beans. I also make a dip with broad beans, Parmesan a bit of mint, garlic and olive oil which I love - you might not be allergic to that ? Perhaps we should start a cook book !

[tangocharlie in reply to Seekingasolution]

Your recipes soudn delicious. Yes my thoughts the same to that ad were 'Yes but what bit of the animal?' lol. I do occasionally also have some chicken bite or nuggety things type things in emergency or if I'm out and get hungry, even though they're processed rubbish. A lot of cooked meat, even say chicken portions, has added sugar in the glazes so always read the carb content on the label. I also try and eat smoked mackerel once a week, either tinned in olive oil or the shrink wrapped from supermarkets. It's qute nice grilled with some green veg and tomato/vegetable/nomato sauce. I can't have fresh fish it's too high histamine. I have tried to eat tinned sardines but just can't stand the bones although they'd probably be good for my bones. After many years of low carb it's just become a way of life but I do have the odd day off - but only a day or the pounds pile on. I also have some low carb conjac noodle, lentil pasta and special low carb wraps in stock but rarely use them, I need to be more adventurous. I make a cauliflower rice by steaming cauli then mashing it with a bit of butter or milk as a rice substitute. I need to experiment more with quinoa as a substitute grain. Another thing I need to get round to learning how to do is keto bread, using almond flour or you can use chickpea flour but I can't eat the latter. I must have a dozen low carb cookbooks adn dozens more with recipes that could be adapted, I just need to be @rsed to use them😆

[Tiggy70]

Many thanks for the link TC. Some interesting stuff to try. I’ve bookmarked it so I can dip in and out of it 🌸

[Pixix]

Very timely, thanks so much! My latest hba1c result is lower, but still 41. Interestingly, because mine has been diagnosed as steroid induced, & because of other medical issues, my norm has been raised to 48 - 52. I was surprised to read that on my results. Another test in 3 months. Will read your info later, thanks! S x

[Oshmar in reply to Pixix]

Mine too, HbA1C exactly the same and struggling to get it down so this is perfectly timed

[Pixix in reply to Oshmar]

I reversed it once, down from 44, using the Keto diet, & I will do it again, if necessary! But not happily at this time of year!!

[tangocharlie in reply to Pixix]

Ha ha yes it is the trickiest time of year to lose weight but I'm aiming for another 4lbs before Christmas to give me a bit of wiggle room over Christmas. I've lost 3 and a half stone so far and could do with another one stone off. I tried keto but couldn't stay in ketosis - what dose do you need to be down to achieve that can you remember?

[PMRpro Ambassador in reply to tangocharlie]

It is next to impossible to stay in ketosis when on pred - one random spike chucks it all out! Some people are lucky.

[tangocharlie in reply to PMRpro]

According to the CGMs I don't get random spikes, but the steroids raise my BS from a waking fasting level (before I take the steroids) of about 5.2-5.4 to about 6.8-7ish 3-6 hours later even if I don't eat anything that would normally increase my BS like carbs. But that rise is probably enough to stop me getting to ketosis. I'm going to try again in late January or February, it'll be an interesting experiment. Thinking about it, if that's what happens just as a result of steroids, and if my maths is correct, then steroids are responsible for about a 20-40% rise in blood sugars so no wonder our HbA1c is higher than the average.

[PMRpro Ambassador in reply to tangocharlie]

Shows the value of finding it out rather than total guesswork - I do think there is a role for them in patients on pred even if only for a short term look at what is happening.

[tangocharlie in reply to PMRpro]

If I hadn't taken the initiative and been curious to know what was actually happening I'd have been bullied into taking diabetes meds unnecessarily. Using CGMs taught me so much and now I'm well informed and in control, which is worth every penny for me.

[tangocharlie in reply to Pixix]

41 is pretty good, especially when we're on steroids that raise our blood sugars daily. I'm delighted I've got mine down from 49 to 40

[Pixix in reply to tangocharlie]

Yes! I was thrilled, but also pleased I can go up to 50 without having to go on diabetes meds…but only while on steroids! I’m proud to be on 1.5mg now!! S x

[tangocharlie in reply to Pixix]

1.5 is fabulous. I'm so pleased for you. A GP I saw (I see a different each time so no consistency) said he'd be happy with a HbA1c of 53 but I wanted to go lower and losing weight has been a bonus. Or maybe it's chicken and egg - losing weight meant lower BS. Either way it's a virtuous spiral once you start to change your diet

[Pixix in reply to tangocharlie]

It’s my third time of going down from 5mg…adrenal insufficiency sickness hits me every time. This time it was dire again, caused huge upset between myself & hubby. Married happily for 44 years, but unable to make it through a 0.5mg drop in steroids. It’s truly horrible at the time, though. I’m still down in spirit & suffering deathly fatigue (but long covid & fibromyalgia & hypermobility all have symptoms of fatigue!) I think you’re right, it’s chicken & egg…I’ve tried so many diets since I was 15, I was born ‘chubby’, & short! Keep up the good work, S x

[tangocharlie in reply to Pixix]

I think your adrenals situation is worth a separate post or it will get lost in this thread. I'm tempted to say keep going but that might not be the answer as it's complex. Sending a virtual hug x

[Pixix in reply to tangocharlie]

It was the subject of a post the first time it happened! But now I’m on the third time I know the score, & what’s likely to happen & how to deal with it. It usually lasts about 3 weeks, in differing degrees, but eventually my thick brain accepts the lowered dosage & on we go!! The first time I stopped, felt so ill I didn’t want to go on living…the second time it was lousy, but I understood it, & the 3rd time it’s still naff, but I’m heading towards the light at the end of the tunnel, & deciding when to try going down to 1mg!! Such fun! S xx

[Koalajane]

thanks for this. As you may know I got out of the diabetic range by eating low carb(nearly keto) and have stayed out of it for the last 7nyears with my latest hba1c being 37.

I do eat 1 slice of Wholemeal sourdough toast for breakfast. This is with peanut butter and the bread goes straight from the freezer to the toaster which seems to alter how it affects my sugars. I don’t eat lunch as that is when the steroids are spiking my sugars and then I usually have a salad for my evening meal., with full fat Greek yogurt and blueberries to follow.

It is good to see people are interested in doing this. I have to say I lost 4 stones in weight as well and feel so much better for it.

[tangocharlie in reply to Koalajane]

you are one of my key inspirations KJ. Let's keep trying to spread the word for the newly diagnosed with PMR GCA or T2D as the doctors don't tell people anything about keeping weight and blood sugars stable on steroids

[Koalajane in reply to tangocharlie]

True and how many are having blood tests to see if they have diabetes

[tangocharlie in reply to Koalajane]

True, I wasn't even offered one for years. And then when the result was high I was summonsed to the diabetes nurse at the GP surgery who gave me totally wrong advice and I knew she was wrong so I did the opposite of what she said as by then I was reading all the Michael Mosley books adn reading stories like yours on here .... and voila!

[Oshmar]

That is so interesting, thank you

[proactive]

Thank you! Good article about blood sugar and the website offers info on lots of other topics as well.