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Hidden Symptoms?

I am a 63 yr old male shift worker (office) just diagnosed with both PMR & GCA. I am also T2 diabetic and have lymphodoema in my lower left leg both of which conspired to my missing earlier symptoms. The "girdle pains" and fatigued legs were tolerated as lymphodoema, shoulder and upper arm pains passed off as muscular(lifting weak leg out of bath) and the headaches as sinus-related. In Mid-December 2012 I suffered a prolonged raise-4 weeks- in blood sugars(around 15.0),which co-incided with a bout of cellulitis.An increase in diabetic meds appeared to resolve this. Comments from work-colleagues about my unusual tetchiness prompted a visit to my GP, where the history was recorded and bloods taken. Recalled to GP 3 days later (high ESR) displaying tender temporal area and headache I was referred direct to Hospital where more bloods;CT scan;Temporal Biopsy; referrals to both Optho and Rheumy were all done in 4 days.With no adverse reactions to steriods (apart from balancing blood sugar-varying from 7.5 to 22.5 daily-now in hand with Diabetic nurse) I now embark on the dietary and pharmaceutical conundrums--- which food & which medication for which time of the day to obtain the optimum balance?

5 Replies

Hi violetsnowdrop,

All that I can offer regarding advice is based on my own experiences with PMR.

The diabetes meds should be taken when advised by your nurse - obay!

Take the meds for PMR/GCA in the morning, after a light breakfast - I use 2 slices of wholemeal toast with olive oil marg. as my food and take my pred with this and no more - the reason - I want to make the pred. hit my body with as much force as possible for maximum effect.

Go for the healthy diet - no refined sugar or food that contains added salt because you are no longer able to deal with either of these culprets whilst on steroids. If you do not eat a diet low in sugar or salt, you will blow up like a balloon and look like I did on the high doses--------FAT!

Just follow the so called 'stone age diet'. It may sound horrendous, but it's easy once you get your head around it.

Unrefined carbs like wholemeal bread, rice and potatoes - with the skin left on etc. Sea food of all kinds and, oily fish if you can stomach it. I can only manage one portion a week, but white fish is good too, as are prawns, crab,shrimps etc.

Red meat in moderation, but cut off the fat.

Eat as many veges as you can, but not too much fruit or honey as they both contain sugar, and your body has real problems with this.

Avoid drinks that contain high levels of caffeine. This substance causes inflammation. Tea is fine, but avoid coffee and cola drinks. If you can then drink lots of water - natural or fizzy. Water will help get rid of the 'baddies' in your diet.

You are working quite a full day, I presume, so eat little and often, with only one main meal a day.

By the way, I have never given up my red wine, in moderation of course. It is a mood enhancer for me and also, the red colouring is a good anti inti inflammatory - it's not all bad so take heart.

Best wishes,



Thanks Pat red wine sounds good .Have had none since went on MTX weekly now on 7.5 mg predisolone .Take care


Hi Violetsnowdrop

Like you I have Type 2 Diabetes and my blood sugar level have been dreadful I was regularly getting readings of between 4 - 6 for the last 2 years and it has jumped to 10 - 15 which as you know is a worry, but due to the steroids etc it mucks about with your blood sugar levels. My Diabetic Nurse is monitoring me as well and has advised to eat healthy.

I am glad to hear that you are doing ok and that with the increase in you diabetes medication has worked. I feel that this may be the case with me as I was only diagnosed about 2-3 weeks ago.

Take Care and know that you are not alone


Hi all so far,

I was given good results for my last blood tests 2 week ago, and by the way I have to ask for a complete breakdown of all tests - and I do!

After over 2 years on pred, during which time I have followed the modern day equivalent of the 'hunter, gatherer diet' , I now seem to be on the edge of being a type 2 diabetic. Teetering on the edge with a reading of 6.5mg. WHAT! I can't do anymore as far as my diet is concerned.

I realise that this disaster is all due to pred - I have tried so hard and deprived myself so much that I feel justified in being cheated by this devious drug.

Another blood test at the end of the month - I wonder what my GP will suggest if the results are the same.

I don't think red wine can have caused this 'spike' in my results and can only say that I have enjoyed this ' nectare of the gods' for years before and after getting PMR, and my sugar levels have always been good. It's not like I'm on a high level of pred. but, I realise I 've been on it for a long time - over 2 years.

The longer you're on steroids, the more likely you are to develope diabetes.

I am rather upset to say the least, but I've tried very hard to eat sensibly, so all I can do is hope.



3 weeks down the line and things are starting to become more orderly (with great assistance from the various bloggers!)

I only sleep 3-4 hours at night since I 50mg Pred (still on that level) so routine is now:-

I take Pred meds early morning with high dose Novomix to try to balance the blood sugars and carbs to balance the Insulin.

After 4-6 hours later I have another meal with my normal a.m. meds.

Then 4-6 hours later statins and other meds accompanied by another Novomix dose and evening meal -hopefully I won't fall over cause I'll rattle like a snare drum!

The Eureka moments have been: (a) using thigh instead of groin for the insulin was more effective; (b) that contrary to initial info by hospital there's a better sequence for taking meds.

Fortunately, the "cave-man" diet is basically what I normally eat anyway- I don't like fizz and have only ever had decaff coffee for last 18 months!

Blood levels have improved to between 7.4 and 15.

Latest update from GP:- temporal biopsy was negative however ESR readings still at 44. Appointment with Rheumy on Tuesday- wish me well because GP has stopped me from driving (I work 23 miles away).


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