Blood tests .

[Viv54]

After having some bloods tests the results came back that i am now in the Pre Diabetic stage. I also had my Drs appointment on the same day. We discussed that i had tried 3 times to lower my dose of Pred to 7 from 7.5 and that i was finding it hard as my quality of life was rubbish with the pain. I like and trust my Dr but with this matter she does or will not think out of the box.She said it is the Pred and i just have to come off it ! I said i know but can not try harder than i am doing atm ! It also turns out i am anemic ,that explains why i am feeling lousy ! She has given me iron tablets for it, if only the rest was that easy. Just feel stuck.

[Gala123]

Sorry to hear you are now pre-diabetic. My blood test came back as pre-diabetic after I had a steroid injection in my knee. It is now back to normal. Interestingly, my GP did not tell me to come off prednisolone. I had an appointment with the practice nurse who discussed lifestyle adjustments with me. I would say that this may be a temporary increase that would not require completely coming off prednisolone but continuing with tapering where possible and watching your diet/lifestyle. It’s really about finding a balance and what works for you. Also, was it confirmed that you have iron deficiency anemia? Before I was diagnosed I was severely anemic, but my ferritin level was normal. This kind of anemia can be caused by inflammation and mine went away on prednisolone and methotrexate.

[Viv54 in reply to Gala123]

Thanks for your reply, mine is the opposite .My Dr is convinced it's the Pred ! My inflammation is not good atm, aching all over .

[PMRpro Ambassador]

You definitely need a different doctor because she is being totally unreasonable.

Have you cut your carbs drastically? That can make the difference and Koalajane reversed her Type 2 diabetes by doing so despite pred. There has been lots of discussion about it on the forum - maybe not easy to find but you will gets lots of advice if you ask in a post with pred-induced diabetes mentioned in the title.

Pred triggers the release of spikes of blood sugar by the liver. If they coincide with the raised BS after a meal in particular then the Hba1c will be pushed up over time - it reflects the average BS level over the previous 3 months. If you cut carbs, especially processed carbs and added sugar and limit fruit as well as looking at the timing of eating you can improve it. Did the GP tell you how high the Hba1c was?

And as a bonus - it helps reduce any pred-related weight gain.

[Viv54 in reply to PMRpro]

Yes I agree and I told her so ! I admit I have been straying from healthy eating, this has given me a wake up call, no I didn't find out about my Hba 1c,I will find out. I just seem to be getting one thing after another atm.! Best foot forward ! Excuse the pun.

[PMRpro Ambassador in reply to Viv54]

I think you are definitely not allone with the straws building up one after another!!

[piglette]

Is your doctor really suggesting you get off the pred so you are then in awful pain? I often wonder whether doctors think we are exaggerating the pain the way they act.

[PMRpro Ambassador in reply to piglette]

It really is gaslighting ...

[piglette in reply to PMRpro]

Gaslighting really sums it up. Good word.

[Viv54 in reply to piglette]

I was shocked , I told her I could only do what I am doing atm, I have to stay on 7.5 after failing 3 times getting down to 7 .She just seem to blame every thing on Pred. I just could not function on 7 mgs .Thanks for your reply .

[piglette in reply to Viv54]

I had a rheumatologist like that. My ESR was over 100 when he diagnosed PMR and he gave me pred. Then the following week he check my PMR and phoned me up and shouted at me as the ESR was still in the high 90s, as if it were my fault. I still don’t know what I could have done to make it go lower.

[SnazzyD in reply to Viv54]

I would love for her to explain the mechanism by which it is causing pain. Perhaps you could ask her in her wisdom to enlighten you.

I have no idea what your pain is like but I did find 7.5mg a real sticking point, feeling fluey achey all over when I dropped. I didn’t have PMR so I don’t know the difference between my pain and yours, but it was enough to make me feel lousy.

[Viv54 in reply to SnazzyD]

Thanks for your reply, I have all your symptoms, I feel it's like toothache unless you have experienced it, it's very hard to explain, she just doesn't seem to get it.It's a shame because she has always been so good , but this time we have reached a real sticking point. But I know for sure I'm not trying to drop until I'm ready, just hope she doesn't stop my supply.

[Viv54 in reply to piglette]

It has made me wonder, but this time she saw I was in real pain at my appointment! Not that it changed the outcome !Thanks for replying.

[Pixix]

Copying &pasting my answer to virtviolin this morning, shows many get this problem! I went onto the Keto diet for 3 months & reversed my prediabetes. My number wasn’t quite as high as yours, but heading quickly in that direction! As a long term steroid user (many years for other medical issues & now 5 years for PMR, I have the test done every 3 months, & dread the results!! Latest one is back last week,& is 41. I’m planning to diet again as soon as I feel better (not PMR related illness!) I would speak to your medics, & ask if you can have time to try& lower it without metformin. Also, I keep getting offered a course onthe subject…there’s a lot of free help through your GP surgery. Good luck.

[Viv54 in reply to Pixix]

Thanks for your reply,yes I'm shocked at my blood tests atm not just prediabitics , but a couple of others not related to PMR.My Dr did offer me a course, I'm going to post on here to see if anyone has done it .Just seems to be one thing after another with me atm.Never mind chin up and off we go 😊

[Pixix in reply to Viv54]

I think you can do the course online now. If you don’t know a lot about nutrition, it’s a good idea, & also tells you a lot about diabetes. But if you can do the diet & reverse it, it’s the easiest…well, for me it was. I’m on the borderline every 3 months now, & wouldn’t be surprised if it’s raised. Had a bit of diabetes in the family!! When I saw a rheumy (for diagnosis of hypermobility, not because of PMR) the subject of fibromyalgia (which I’ve had for 14years) and PMR, came up. He got very very agitated & paced the room & shouted at me, told me I must reduce by 1mg a month (I was on 5mg then), & then have a blood test in six weeks. He said the blood test would trigger another appointment with him. So I didn’t get the blood test done!! I had one done at our surgery & manage PMR with my GP. Much smoother…but it was a shock when he told me I had Addisons disease & must get off steroids NOW! I’d had a hard time with adrenal insufficiency issues in the 3 months prior, but he said it didn’t matter how sick I was, I must stop the steroids!

[PMRpro Ambassador in reply to Pixix]

Did he know the difference between Cushings and Addisons? And what no steroid replacement does to Addison's patients?

[Pixix in reply to PMRpro]

I think there’s a lot he didn’t know, or understand! But he put Addisons in the letter he wrote to my doctor. I was not copied on the letter, but it’s open on my notes for me to read.

[Viv54 in reply to Pixix]

That's shocking,especially when we know what the outcome Can be !

[Pixix in reply to Viv54]

Absolutely, but that’s what out there sometimes! He was annoyed as I’d been seen twice by his colleagues. At onebpo7nt he stared at my notes & said ‘oh I see you’ve been to orthopaedics, too’ & I said yes, haemgioma on my spine…’oh he said, neurology, too’ … yes I said ‘diagnosing essential tremor’! He made me feel like I’d been to too many departments & was just a nuisance. First thing I did when I got home was type it all down, so I have good recall of it, & able to use it if I ever need to!!

[Coffeebeans]

I nudged into the prediabetic range when on pred, and due to huge weight gain.

I've lost 4 stone and changed my diet and now it's completely normal. Diet is key and I signed up with a nutritionist who was great. It's not the only way but I would say increase fibre as much as possible and cut refined sugars completely. Restrict complex cards too, and only eat them during a meal - not as a snack.

Reducing the pred isn't the answer. You will feel rubbish and that's not a good way to motivate yourself.

Perhaps when the anaemia is better thing s will improve.