Prednisone and Diabetes ????

[Debbie C]

I read Steve from Colorado story where he got diabetes from steroids and I was wondering if that has happened to more people. I'm asking because I had blood work done twice last month ( for 2 different drs. ) but both happened to check my lipid panel and hc2 ( which the hc2 has never been checked and I guess that is a marker for diabetes ) My triclyerites went up about 90 points in just a few weeks and the hc2 was just above normal. I asked my dr. about it and he asked if I had been eating alot of sweets..which I don't, then he said it's probably the steriods and we need to keep in eye on it. So I had to get my monthly bloodwork done yesterday,don't have the results yet. But after reading Steve's story, I googled it and diabetes is a common side effect from prednisone and it can come on anytime even when you lower or wean off. I'm thinking about weaning off now I'm worried about getting diabetes.So I was wondering if anyone else has been tested or has diabetes or has high glucose levels ????:w00t:

[BookNut]

Well....breathing and other life functions are important, so you may have to make some dietary changes while on pred. even if you are not a sweet eater.

After being on three pred tapers, my sugar levels went up at my last check-up. I also recall that when I was in the hospital with massive doses of pred, my sugar level went very high. They put me on a low carb diet. It was pretty yucky because they also insisted it be low fat, which meant a lot of artificial ingredients. My doctor is a big proponent of a High Fat, Low Carb diet...but she had no control over the rules that the hospital doctors and food service go by. Anyway, You might see what happens by eliminating packaged foods, especially those that say low fat. It is surprising how much sugar is in processed food. Switch from skim or low-fat to whole milk, half and half, or cream. The higher the fat content the lower the sugar content. I love coffee, so i have found that having a cup of coffee with heavy cream has cut my sugar cravings to almost nothing.

The big thing is to remember that it is not only sugar that raises sugar levels. It is carbohydrates, including fruit and starchy vegetables. I don't count calories, I count carbs and try to keep it to no more than 100-115 carbs per day. This is very generous, compared to Atkins. I will get my blood work done next month. so I will see if it is enough.

It is pretty easy to know which foods are high in carbs. They are sweet things like fruit, anything made with flour ( even gluten free) and any vegetable that grows under the ground...potatoes, carrots, even onions. I have NOT cut those things out, except for bread, cookies and cake. I just eat small portions and not too many in one day. i lost nine pounds in three weeks, and then leveled off. I would have to lower my carb count to lose more, but am not willing to do that unless my labs are bad. I am feeling much better and hope to start my walking regimen again soon. That will take of the rest of the pounds i'd like to lose.

Bottom line.....if you need prednisone, you need it. There are other ways of warding off diabetes while you are on it.

[drz]

Pred made my diabetes worse and made it harder to control my blood glucose levels. Even though I am down to 5 mg of pred I still have higher BG levels as measured by my A1C levels. I am using almost twice as much insulin now as I did before Wegs. But diabetes is also a progressive illness so it may not all be due to the Wegs and Pred.

[windchime]

Pred made my diabetes worse and made it harder to control my blood glucose levels. Even though I am down to 5 mg of pred I still have higher BG levels as measured by my A1C levels. I am using almost twice as much insulin now as I did before Wegs. But diabetes is also a progressive illness so it may not all be due to the Wegs and Pred.

Me too waving my hand wildly in the air. For some reason my BG has really skyrocketed in the last couple of months, probably due to the pred. I too am at double my previous insulin level from just two months ago. I'm down to 10mg too. My doc is not happy.

[Debbie C]

WTH !!!!!! I'll have to see if my bloodwork is done for me to get a copy of it tomorrow , so I don't start panicking for nothing.

Thanks for advice Jacquie, I really try to watch what I eat. I don't eat packaged lunchmeat,I drink my coffee black. I do eat packacked frozen fruit on my oatmeal in the am, I'll have to see how much sugar that has and I will start watching my carb intake, maybe I can lose that last 8 lbs. I've been trying for.

Drz and Cindy...do u think it can be the lowering off the pred that is making it worse. When I googled it ,it said that weaning and stopping can make it worse. The dr. said I can get off it if I want but now I'm afraid of getting diabetes. I had no idea pred gave that to you.....

[windchime]

If the BG spikes from getting off pred I wouldn't think it would last forever. I'd rather be off the pred since diabetes can be controlled.

[mishb]

When I first started on this journey, my Rheumatologist told me to purchase a blood sugar monitor and check my bloods once a week.
She told me it was because the prednisolone that we have just put you on can cause diabetes and you need to get it checked out each month and since it costs money to go to the doctors each time, you might as well monitor it yourself and then go to the doctors if your levels rise.

Therefore I did mine once a week, back then, now I do them once a month and my doctor does then probably once every 6 months. In fact I have a form for the end of this month for a full glucose test together with cholesterol and the works.

I recommend to anyone on pred to purchase their own monitor and check it themselves. It's better to be safe than sorry

[windchime]

When I first started on this journey, my Rheumatologist told me to purchase a blood sugar monitor and check my bloods once a week.
She told me it was because the prednisolone that we have just put you on can cause diabetes and you need to get it checked out each month and since it costs money to go to the doctors each time, you might as well monitor it yourself and then go to the doctors if your levels rise.

Therefore I did mine once a week, back then, now I do them once a month and my doctor does then probably once every 6 months. In fact I have a form for the end of this month for a full glucose test together with cholesterol and the works.

I recommend to anyone on pred to purchase their own monitor and check it themselves. It's better to be safe than sorry

If you can get your doc to write a script for it your insurance may pay for it. The machine itself isn't very expensive, around $50, however the strips can get pricey. Just a thought.

[Debbie C]

I was never told that pred can cause diabetes so I was in shock when "tanker" mentioned it. I know all the other medicine can cause cancer and other things. I think I'm gonna try to taper off. It's like damned if we do and damned if we don't:unsure:

[ingemlb]

Debra I think consider it carefully. There are worse things to deal with than diabetes as that can at least be controlled by diet and insulin. I became diabetic within 2days of starting pred. The specialist called it pred induced diabetes and chances are it will reverse once (if) I get off the stuff. I had been prediabetic for years controlling it with diet and exercise . I was given a choice of meds or insulin so decided on insulin as it is a) much cleaner and natural and b) much easier to control. My sugar jumps up between lunch and dinner as I take the pred with lunch. I have to take a mix of insulin (fast acting and slow release) which comes pre-mixed in a pen so it's very easy to use. I am on a very low dose. 20 units once a day. Like I said for me the diabetes is the least of my problems but without the pred I would be lost right now.
Diabetes only becomes an issue if you let the blood glucose get consistently too high. The excess glucose in your blood is what causes all the damage. I measure my blood glucose 4 times a day so I can learn which foods have an impact. The specialist only requires 2 measurements a day but I feel more in control with 4. I find I need a mid morning snack or by lunchtime I get the hypo shakes other than that it's pretty smooth sailing. Of course in my case there is no guarantee the diabetes Will reverse. I just hope it does and I live in hope of getting off the pred. Can't stand my ballooning face. In fact the weight in my opinion is far nastier than dealing with the diabetes!

[Debbie C]

Well I went and got my blood tests back and my glucose is at 85 which the range is 74-109 and the A1c went down from 6.1 to 5.9 which the range is 4.8-5.9,so I'm still right there on that. Do they go more by that number or the blood glucose? I still think I'm going to try to get down to 3 mg,I've been at 5 for almost 2 1/2 yrs now ,I think. Is any one on any cholesterol meds. I can't get mine down no matter what I do, my dr. wants to put me on med. but I keep telling him I want to try to lower it naturally but nothing is working. I was wondering if that can cause diabetes. I just HATE needles ( I would be a terrible drug addict )
Inge,you got diabetes just 2 days after starting Pred:sad: could they not have but you on a different kind of steroid or wouldn't that have mattered ?

[ingemlb]

To tell you the truth Debra I didn't ask if there was anything else. I was extremely ill and the Pred started working within 24 hours. They knew I had vasculitis in all joints of my body but hadn't been able to form a diagnosis beyond that. IT was crucial to get the inflammation down. I had waited until the last minute to show up. In fact when I later was writing to my GP to explain why I was on steroids (my previous GP is anti steroids) the doctor in charge of me at the hospital asked was I writing a novel. I mentioned my predicament with my GP and her reply was "Just tell him if it wasn't for the PRed you wouldn't be writing this story".

So I guess it was rather serious at the time. I was spaced out on Morphine, Tramadol, Panadol Osteo and Oxycodone simultaneously and still nothing took away the pain. I had been in this extreme pain for the first week in hospital and it wasn't until the pred started that the pain shifted.

So I was totally not worried about the diabetes. I figured it will either clear after I finished with the pred or I will get rid of it when I lose weight once I am feeling better. I had been looking after my mother who was on insulin for over 40 years so I had no fear of it. But I know that my son badly needs it but they are mucking around with meds because he doesn't want to inject and problem is he won't control his eating either so his blood glucose is usually out of control :(

To tell if you are truly diabetic they need to do a fasting blood glucose tolerance test. That takes 2 hours. You arrive, they take your blood to get the fasting reading, they give you a bottle of glucose to drink. They then take your blood again in 1 hour then 2 hours. Those readings are all very important because it will tell them a) how low your glucose is on fasting and how quickly the glucose is processed by your body after food. Our values here are different to what you quoted. Fasting needs to be under 6.0 and the 2 hour test from memory needs to be under 12. Even 12.1 will make them come back with a diagnosis of diabetic.

I am totally anti cholesterol meds. They are finding out that they only act as bandaids. It's not the cholesterol that causes plaque but inflammation in your arteries will convert the cholesterol into plaque. So unless you can get rid of the inflammation in your body (bit hard in our case) you won't be shifting the plaque even if your cholesterol is artificially lowered by statins or whatever they prescribe. A lot of controversy over it at the moment. But the cholesterol industry is a huge money spinner and they canvass the medical professionals very hard to prescribe the stuff :(

[windchime]

Well I went and got my blood tests back and my glucose is at 85 which the range is 74-109 and the A1c went down from 6.1 to 5.9 which the range is 4.8-5.9,so I'm still right there on that. Do they go more by that number or the blood glucose? I still think I'm going to try to get down to 3 mg,I've been at 5 for almost 2 1/2 yrs now ,I think. Is any one on any cholesterol meds. I can't get mine down no matter what I do, my dr. wants to put me on med. but I keep telling him I want to try to lower it naturally but nothing is working. I was wondering if that can cause diabetes. I just HATE needles ( I would be a terrible drug addict )
Inge,you got diabetes just 2 days after starting Pred:sad: could they not have but you on a different kind of steroid or wouldn't that have mattered ?

Debra the A1C gives a picture of what your BG levels have been over the past 3 months or so. Sort of an average. The BG, in your case 85, gives a picture of what is happening right now. I don't know if this will help alleviate your fears, but usually they start you out on pills--Metformin usually. You don't have anything to worry about right now from the looks of your numbers.

Red Rice Yeast, a supplement, helps to lower cholesterol. You can find it at most pharmacies or grocery stores. It worked well for me when I was taking it.

[ingemlb]

Never heard of Red Rice Yeast Cindy. Must investigate. Thanks for mentioning :)

[Debbie C]

Thanks Cindy and Inge for the info, so I quess to be sure I need to take a glucose test ? I thought the fasting monthly bloodwork would tell. I started to lower my pred this a.m. I took 4 1/2 instead of 5mg. Those little things are hard to split ,I'm gonna see if the pharmy will split a few for me,but with just less than half I can feel my body shaky inside. It's going to be a slow ride with this.

[tankerB25]

ingemilb, it seems that our Doc's are on the same page. I was told the Pred causes diabetes "sometimes" and usually in people who are "pre-diabetic", which I was. I too was trying to control it but with diet and exersize and was having good success...untill WG and Pred! I am taking NPH insulin and reducing it as my pred is reduced I'm down to 7-5 of pred and 5 units on the Nph once a day. My doc said that as the pred is tapered down the need for insulin would go away but I would likely be on metformin for ever. Moonface is mostly gone and I'm working on the weight I gained over the past year or so. I agree with your advice to Debra C the diabetes is not as bad as a flair especally since you never know where a flair will hit your body.
'

[windchime]

Thanks Cindy and Inge for the info, so I quess to be sure I need to take a glucose test ? I thought the fasting monthly bloodwork would tell. I started to lower my pred this a.m. I took 4 1/2 instead of 5mg. Those little things are hard to split ,I'm gonna see if the pharmy will split a few for me,but with just less than half I can feel my body shaky inside. It's going to be a slow ride with this.

I wouldn't worry about a glucose tolerance test unless your doc recommends it. My docs made the diagnosis with the A1C, I didn't have a GTT. That's just me, but you can ask you doc to be sure.

[Debbie C]

Hey TankerB25, I used to live in Denver and worked at a club in Englewood called "The Dove" this was about 20 years ago so I doubt it is still there but they used to get Ike and Tina Turner and some other big names in there. I loved going camping in the mountains,but that was another life !!!! I am currenty in remission,so they say, and see a rhuemy at Cleveland Clinic. I have a very low tolerance for meds and have only been on pred for the last 2 1/2 years., so he said if I wanted to try to get off them I could. That's why I am stating this taper now...I may get to 3 mg. and stay awhile ( if I can make it to there ) but I was shocked when u mentioned steroid induced diabetes,noone ever mentioned that to me.So u think once u get off the preds u will no longer need insulin ??? What is the metformin for ..to control the sugar ??? Nice bike by the way !!!

[ingemlb]

Hi Debra. that's the thinking however no guarantees. In some people I am told the diabetes does not reverse itself. Maybe it all depends on how long you have been pre-diabetic etc. MY Endocrinologist calls it "steroid induced diabetes" and is confident it will go once I am off the Prednisolone. Maybe the length of time on it is also a factor.
There seems to be a very strange form of diabetes in my family. Mum was diagnosed at 40 and hers was clearly type 2. She didn't attempt to control it and had to go onto insulin in the end at which stage she started to feel much better. Hers many have been linked to life-style as she struggled with being overweight. Mum slowly developed the complications of diabetes. Especially with her eyesight and eventually with peripheral Neuropathy in her hands, bad circulation in her legs.

However my father's diabetes was strange. His developed very suddenly and he had like me a lot of peripheral neuropathy in the feet almost immediately on diagnosis. His diabetes was sudden onset yet within no time he had to be on insulin. He was not overweight. His father was definitely not overweight and his diabetes was discovered by my aunt one day when she saw under his trousers his leg was looking black. He was in his 60's and nobody had had any idea he was suffering with diabetes. His father ( my great grandfather) was also discovered to have diabetes after his leg was damaged so badly it needed amputating. From photos it is obvious he was not overweight either.

I developed almost overnight this patchy numbness in my feet. Suddenly in late 2005. No pins and needles no pain. Just numbness under both feet and in some toes. I saw a Neurologist early 2006 ho diagnosed "diabetic Peripheral Neuropathy" however I had never had diabetes but this chap told me that we sometimes get the complications of diabetes before onset of the disease.

The Endocrinologist at the Hospital earlier this year doesn't believe the diagnosis. He doesn't believe my Peripheral Neuropathy has anything to do with diabetes or pre-diabetes. The nerve conduction test was redone and this time all major nerves were found to be normal. So the numbness must be in the small nerves which don't show up in nerve conduction tests but need to be biopsied to prove it. Yet the Neurologist who saw me earlier this year was convinced it is linked to pre-diabetes.

So I am not sure who is right. If indeed I have been suffering from pre-diabetes all these years then who knows if it will reverse itself after getting off the prednisolone. If my diabetes is similar to my father's and his ancestors then it seems a rather nasty type that starts in the 60's and needs urgent management.

Tankerb25 I am on Novomix Insulin which is a mixture of rapid and intermediate acting insulin. I take 20 units in the morning and it keeps working for 24 hours. As I have only just reduced the pred from 40 to 30 it has so far not been reduced. I do notice I am getting close to hypos by lunchtime. I take the Insulin at 9am with breakfast and usually need a snack before lunch or the blood glucose drops below 4. Then with lunch I take the PRed and this makes the sugar rise rapidly and it takes until supper time to go down again. As I need to eat with all meds I take I usually have another snack before bed time and on waking my blood glucose is usually around 6. I think next time I drop the Pred I will probably have to reduce the Novomix.

As to the peripheral Neuropathy I tend to agree with my Endocrinologist that it is more likely linked to Wegener's than to the pre-diabetes. But ... who knows!!! I do know that since things went out of control with the Vasculitis early this year I have had for the first time pins and needles in my feet.

[drz]

Debra the A1C gives a picture of what your BG levels have been over the past 3 months or so. Sort of an average. The BG, in your case 85, gives a picture of what is happening right now. I don't know if this will help alleviate your fears, but usually they start you out on pills--Metformin usually. You don't have anything to worry about right now from the looks of your numbers.

Red Rice Yeast, a supplement, helps to lower cholesterol. You can find it at most pharmacies or grocery stores. It worked well for me when I was taking it.

Since the A1C is an average, it can be very misleading about condition of your diabetes. You can have a normal A1C level and have many too high readings offset by many too low readings. Your daily range is more important. Your BG readings first thing in morning before you eat should give you a good idea of how you are doing. Most people find their readings go up in early morning as the body is getting ready to wake up so it starts making more glucose to help get you going but it should still be around 100 or close. Anything over 110 should warrant closer monitoring. Same if under 75. After eating your BG levels will normally increase for a couple hours but they should not get too high if your body is working well. If they are, again getting further evaluation.

[tankerB25]

Hey Debra C, don't remember the Dove but Englewood was never really my stomping ground I usually lived outside of town Baily, Parker, Castle rock, Broomfield, etc. I do love the mountains and hope to be able to walk well enough (WG has caused me to lose feeling in my feet, just recently worked my way from a wheelchair to braces and crutchs to no braces and a cane but my feet still suffer from the nerve damage) to hit some of those trails in the foothills. I'm also in remission and scheduled to have infusion of rtx tomorrow and another 2 weeks from now. My Doc says it's "likely" I can stop the insulin after the pred is reduces to almost nothing or gone completly. Yes the metformin is to control the blood sugar he has said he thinks I need that forever. I think a lot of this stuff is, lets just see how it goes and adjust acordingly because everybody is different! I think ingemlb's post is really spot on, great info ingemlb, family history, lifestyle and possabily enviromental issues all contribute to health issues.


Thanks for the comment on the bike I used to love to ride through the mountains. Don't have it anymore but everytime one goes by on the road I remember the freedom! That your bike?

Steve

[Debbie C]

Steve if you are in remission why are they giving u infusions of rtx,that's usually used as a hard hitter for this disease or some have used it for maintence so I thought?! Sorry to hear all the trouble you are having with your legs but you seem to be improving and hopefully soon u will be back to " normal "
No that's not my bike, I was thinking about getting it, I'm so short that was the only one I could actully sit flat footed on. But my boyfriend has 3 Harley's and a custom chopper that he built and shows so right now I just enjoy being the passenger.

[tankerB25]

Debra, the rtx infusion is something that is used every 5 or 6 months in a lot of cases or so I'm told. I think I have seen people on this site who also are on a maintenence of rtx once or twice a year. I think that after a while that will stop but for now it that's what it takes to keep the flair's down...hook me up doc! Wow 3 Harley's and a custom bike...nice...I used to love to go to the big swap meet at the stock show complex here in Denver...tons of great stuff but leave most of your cash at home it was all to tempting!!

Steve

[Auntie TooToo]

I have been what my pcp diagnosed as "pre-diabetic" for several years and was well controlled by diet and exercise. But that was before WG and pred entered my life :predrage: Now, for the last 6 months my BS has been extremely high; at one point it would not even register on the meter. My pcp ended up referring me to an Endocrinologist {just what we all want right, another md} for this and a thyroid bx as well. Now, I am on glucophage 500 mg bid & Insulin 4 x day to control BS ... but it is getting better thanks to an excellent md! It's difficult sometimes when rheumy or pulmonary change pred dosage, but we just have to adjust the sliding scale of insulin to keep it down. I believe you also mentioned you lipid profile {mainly your triclyerites} being elevated; my endocrinologist has noticed same with my blood work. He mentioned that pred can also affect these levels and we just have to keep a watch on them; in the mean time do what we can by diet to keep down.

[tankerB25]

Hi Auntie tootoo it wasn't me who mentioned the lipid profile but my triclyerities have been high. I was controlling that with diet and exercise, like you, and like you pred did a number on that! Being down to 7.5 o pred I have reduced my insuliln to about 5 units and my BS had been pretty good. I'm getting a little exercise now and that is helping too. And of course having a good Dr. or Drs. makes all the difference in the world!