On the suggestion of one of the kind members in the group, and following my recent PMR diagnosis and the start of15mg Pred with accompanying increase of glucose levels, I got hold of one of the monitors free of charge from Abbott
It arrived the following day and I have to say hiw impressed I am with it!
Yet again another kerning curve!
I was referred to the diabetic clinic where I visited yesterday to discuss diet etc so I think it is going to take a lot of pressure in deciding when and what not to eat in the light of dietary issues surrounding PMR
.So thank you for the advice !
Written by
Bridekirk
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I was diagnosed type 2 (steroid induced) and got into remission 6 months later. I basically ate ket, very low carbs. I still eat low carb but not keto and have been in diabetic remission for 7 years. I don’t use a CGM just a monitor with finger prick
I had not originally grasped that the two conditions were connected, but I'm hoping this monitor will keep me on track so that I can tackle it as I follies the path and keep it at bay.
The monitor is good insofar as it makes a warning sound each time you go over 10 so I can then find it easier to understand what happened to make the alarm sound right on the spot and name adjustments
I found that prednisolone raised my blood sugars about 4 hours after taking it and it stayed up for about 5 hours. I therefore avoided eating in this time.
Have you had a hba1c blood test to see what your blood glucose is?
Hi. Yes it's in the pre diabetic stage which is why I am anxious to control it ASAP. I had a spike when I woke up then another about half an hour after lunch 1t 13.5.
It's just my first day with the monitor so don't have any patterns to follow.
I had the bloods 5 days after starting on pred and before that it was over a year since I did full bloods to I don't know if its the pred or was already an issue
It's the prednisolone that causes the glucose spikes. As Koalajane, Tangocharlie and I have found the spike period lasts for several hours after taking the pred. After that, blood sugars are more normal. The spiking effect gets much lower as you reduce pred, particularly under 5. For instance you refer to a 13.5 after lunch. That would be in the spike period. I found that if I ate say half a pizza at lunch it would go to something like that, but if I had it for dinner it would be a more acceptable 9. So the moral is to avoid carbs during the spike zone which seems to last between six and ten hours. When you are used to your CGM could you report back your findings? X
my husbands been trying a glucose monitor, nor pmr just general prediabetes and its helping stop spikes, and he has gone down from diabetic level blood sugar to prediabetic since using it for a month. Basically common sense, more salads fewer carbs and sugars but very interesting to see the effects
There is a lot of discussion about "normalising" the use of CGMs but if they once realise how much they can empower the patient to modify eating patterns I'm sure there will be more support. You don't need one for ever - just long enough to identify your personal "poisons" and how YOU can modify your levels.
I assume you will be financing the sensors yourself so find when you spike and perhaps do not use the monitor all the time. These things are expensive when self funded and even test strips are expensive at over £10 for a tub of 50
Though a couple of weeks is enough to get an idea what is helpful or problematic and maybe another sensor later on after a gap, to see changes Not continuous or long term in this use case.
That's what I do. I reported on findings at 9mg and was looking forward to reporting at 5. Unfortunately I am now on 20 and won't be able to face looking at the difference until after Christmas.
I am fortunate and have been using a CGM(freestyle libre 2) over 6 weeks (3 sensors)and whist they are quite expensive, are not perfect in themselves and often do not correlate with finger monitor readings i have found even as a non diabetic a GCM is a very good tool to resolve damaging dietary foodchoices and understand the spiking capacity of individual foods which i used to eat quite frequently. Personally i have found the cost to have been worth every penny given the benefits i have achieved.
Over the period i have reduced my average 24 hour average blood glucose from 115 mg/ml to 96mg/dl, my A1c has dropped from 5.6 to 5.2, (even though A1C levels are 3 month based averages) and the most alarming/beneficial impact has been the major improvement in my energy levels, and mental focus/improvement, along with a number of gastronomic issues i had which seem to be moving rapidly to being fully resolved.
It is surpising to see the scale of glucose spikes when first using a CGM and even up to quite high and damaging levels in some cases and also to experience the bodily/mental benefits you feel as you mange these spikes and your average 24 hour glucose level recedes.
I agree with many of the comments that there is no need to use CGM's for a long period unless you are perhaps diabetic but as an aid to understand your diet and spikes profile and reduce them. a CGM is an excellant/invaluable short term tool to help anyone to do that.
Another related benefit, as an advocate of intermittent fasting and someone who likes a red wine or two after/during my evening meal is that during and after red wine your blood glucose will reduce quite markedly and on through the night/early morning to the point i was setting my CGM low glucose alarm to wake me up so i could take a sweet or two to lift it into the safe zone(+70mg/Dl). The need for this has disappered over time but the reduction in blood glucose from the time i finsh my dinner/wine (usually befor 9pm) and the lowered 12 hour glucose that drives maakes a consideraable difference in your overall average 24 hour glucose levels.
Whilst i wouldnt advocate drinking red wine as a means of reducing blood suger i have found my 2 wines three nights out of 7 in a week , which i enjoy, has given the additional benefit of markedly reducing my average glucose.....in addition as far as i can tell many medical studies support 2 glasses per night for males, 1 for females as healthy for heart and sugar control especially with Pinot Noir red wine which of all the wines has the lowest sugar content of all the red wines and also contains resvatorol as an anti oxidising agent.
As always i dont suggest you follow my example, the level of glucose control achieved from my above experiences can vary from person to person, but after appropriate consultation with your own medical advisor my above experiences may be of value as i have found it has made a tremendous difference for me personally and turned me down a much healthier path along life's journey.
Fascinating incites Expat Ray and in the very shirt time I have had my first monitor it has ( in respect of Glucose issues rather than direct association with PMR ) been so far a great aid to understanding issues relating to blood sugar and a great way ( even if imperfect ) of helping to keep on the via media.
If I were in the fortunate position to maintain this method of ongoing observation I would have no hesitation, however the cost fir me is absolutely prohibitive apart from perhaps engaging again in 6 months or so to see if I have remembered the lessons learned from the up and coming remaining 13 days
Very informative, thank you! Would you also be able to see if the timing of the food in the pred spike zone makes any difference eg by trying the same food for lunch and dinner? (See my reply to Bridekirk above for more info.)
I wonder if the forum has come up with something 'new' about the duration of pred spikes that could be helpful for anyone taking long term corticosteroids.
I think we may well have done. I remember telling Prof Mackie about what we say about cutting carbs to reduce weight gain and that it also seemed to have a beneficial effect on steroid-induced diabetes and she seemed surprised and wondered whether more dietary advice should be offered. I think it probably is in other countries. But the US and UK seem to have a love affair with handing over pills having assumed it is unavoidable. In the US of course there is a big incentive for doctors to "do" things to earn their daily bread. If you know what to do with diet you are likely to have less need to see a doctor.
There was the Matteson paper saying that actually the adverse effects are similar in pred and non-pred subjects, I know from personal experience that some of the so-called pred adverse effects are also present in PMR patients who aren't yet on pred. Last time we looked, I have had no sign of steroid induced diabetes in 15 years on pred.
I really don't think that notoriously unreliable official observational studies would find any more than we have established - you don't necessarily gain weight or develop diabetes when on pred - lifestyle changes can help reduce the risks.
how do I set that up, just put up a new post?....i am happy to do that as from many metabolic health aspects elevated sugar and its bigger brother fructose, along with their blood relative insulin are fast becoming recognised in the medical community as the source of many if not all metabolic health conditions. In fact heart disease and the vascular inflammation which comes from high sugar consumption is now clearly recognised as the main source culprit rather thathan elevated LDL, the statin related culprit of old.
White wines have a similar effect but have slightly more sugar content than the dry red wines...white wines also have much lower resveratrol content which is one of the more important health aspects of red grape wines.
I can't speak to the glucose reduction comparison between white and red as i am a strictly red wine guy......
Depends on your white wine - the Germans actually label low sugar wines as suitable for diabetics!! Obviously resveratrol is lower in white - but my day to day preferred tipple is an Austrian rose and that is also fairly high in resveratrol - win/win 🥂
I don't know which cgm you have but most of them give you an online report which accumulates data as you progress daily.I copy these daily profiles onto my PC and mark the spikes with the meal I have taken or exercise period I had or other activity.
Don't know if you have come across this,but aas a general guide line that i use, any food product that has a carbohydrate to fibre ratio of 5 or more(carbohydrate/fibre in grammes) that will create significant spikes and when a ratio of 5 or less then check the sugar levels and if below 1.51.gm you should be ok
with food products these days having quite detailed nutritional info on the packaging ththe above quick check can be very useful in your quest to reduce spikes......
it's the same one i use and after using 3 sensors i have realised that often for higher sugar levels and fast spikes sometimes the diffrence between the finger monitor reading which is actual blood sugar levels can vary quite a bit from the intercellular reading from the sensor.
It pays in my experience Not to pay too much attention to the actual numeric levels but more the trends......and try to reduce the spikes for any which.which.come up to between 70-140 if non diabetic, for 95 % of the time with rare eexcursions to under 180 if at all
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Pred affects glucose...what about thyroid? 
TO DO LIST (??!!??)
Weight loss due to PMR?
