Prednisolone

[Jackie2406]

New Year diagnosis -type 2 Prednisolone induced diabetes. Now weaning off prednisolone, but not yet seeing much difference. Glucose levels go up to 20mmols + in the morning -eventually falling to a more normal level late afternoon. I'm finding that I feel very light headed with the usual hyperglycaemic symptoms throughout the morning & then shaky as the levels fall. I don't feel safe to drive etc & have been signed off work. to walk my dogs & do normal household chores is exhausting. Ive been given Metformin 1g BD. Has/is any body else experiencing similar things? How long did it take your glucose levels to fall? i'm on 15mg prednisolone (was on 30mg at New Year) & not seeing much response in the mornings

 

[TorqPenderloin]

I've heard it takes a couple weeks.

Not to scare you, but did they confirm you don't have type 1? Prednisone was how I found out I had diabetes. I'm amazed it's prescribed so recklessly. It is h*** on your blood sugar levels.

 

[mrspuddleduck]

Hi @Jackie2406 how long have you been on prednisolone in total? If it was a long term treatment then you may be going through a pred adjustment withdrawal 30 to 15 since new year sounds a bit quick to me (for a long term pred user). Sue x

 

[Sunny]

Hello. I too was diagnosed with Prednisalone Induced Type 2 (although I was told it was Type 4 when it's caused by steroids?!!!) almost 4 years ago.
I have severe allergies & asthma & have been on steroids for about 8 years!! I take a maintenance dose of 10mg daily - although whenever I have an exacerbation of my asthma or a serious allergic reaction - I have to up my dose to 40mg for a week & then step down.
When I was first diagnosed my BS levels were over 16. After finding this site I started on a LCHF diet (no drugs at this time) & my levels dropped to an acceptable level within about 10 days.
My Consultants have been trying to get me off steroids for years but to no avail!! I have to accept that I would be dead without them though?!!!
I really hope you manage to get off the steroids.
Are you following a LCHF diet?

 

[ladybird64]

Sunny, just a quick message before I'm off to bed - as I mentioned before, I was on them for the best part of thirty years (have been ventilated in ICU a few times), severe allergies to the usual suspects too. I no longer take them. There was no sudden miracle (although when my weight went down my breathing improved), I was also (to my shame) a smoker. Mental health issues had a part to play too so quite a lot in the mix.
Anyway, it gradually improved, I have to take the Ventolin a fair bit but am off the Pred at long last (gradual process). Actually, it's ironic I'm posting this. I have a supply of Pred in case I need them urgently and this evening, I had to use them. Found some mould on one of the windowsills kind of hidden out of view so I decided to clean it all off - forgot I was allergic to mould! Piriton, nebuliser and Pred later, I'm on one piece - just. Don't give up hope, one day you may come off them

 

[pleinster]

Hi. I was put on 25mg prednisolone daily almost a year ago as apart of anti-rejection treatment following a kidney transplant, and that induced "new onset diabetes" as I was warned it might...this was later diagnosed as Type 2..levels of around 20.0mmols. Gradually the dosage has been cut and I am now an 5mg daily. My levels have been brought right down by low carb dieting and nothing else as the pills I was given seemed ineffective. My lifestyle did no cause my diabetes..the steroid did (whatever anyone else tells me) - I still clearly get a spike from the steroid which peaks some four or five hours after taking it...yes, it's lower than it was, but it can still hit 9.0ish, where all other levels throughout the day are under 7.0 now. I want to cut the dosage to 2mg next month, but there is hesitancy as I don't want to risk rejection. however, research is indicating that the drug is prescribed post transplant as it has been for decades and there's fear of risking stopping it despite the use of other stronger anti-rejection drugs (which I am also on), and I understand that. I'd like to come of fit altogether and hope it may allow me to fully reverse my condition, but evidence suggests that prolonged use of prednisolone (ie, 6 months plus) where diabetes has then been diagnosed..leaves you with diabetes even after coming off the drug. Still..time will tell. I would add - I new diabetes was risk in renal transplant patients because of this drug, and I'd rather have diabetes than have to rely on dialysis. Interestingly many clinics are now stopping the use of it in such patients - relying instead on other drugs. Sorry - I do go on and on and on....

 

[Mybesteffort]

I was prescribed prednisone for a very severe poison ivy reaction (blisters all over my legs and couldn't walk). I was told it was important to follow the medication course. Don't just stop. Follow your pharmacists advice on how to take this medication. I did not like the medication because of side effects. I followed my course and withdrew as prescribed, I am not sure if this is the same drug . Anyway, a pharmacist is a very good resource.

 

[ladybird64]

Hi. I was put on 25mg prednisolone daily almost a year ago as apart of anti-rejection treatment following a kidney transplant, and that induced "new onset diabetes" as I was warned it might...this was later diagnosed as Type 2..levels of around 20.0mmols. Gradually the dosage has been cut and I am now an 5mg daily. My levels have been brought right down by low carb dieting and nothing else as the pills I was given seemed ineffective. My lifestyle did no cause my diabetes..the steroid did (whatever anyone else tells me) - I still clearly get a spike from the steroid which peaks some four or five hours after taking it...yes, it's lower than it was, but it can still hit 9.0ish, where all other levels throughout the day are under 7.0 now. I want to cut the dosage to 2mg next month, but there is hesitancy as I don't want to risk rejection. however, research is indicating that the drug is prescribed post transplant as it has been for decades and there's fear of risking stopping it despite the use of other stronger anti-rejection drugs (which I am also on), and I understand that. I'd like to come of fit altogether and hope it may allow me to fully reverse my condition, but evidence suggests that prolonged use of prednisolone (ie, 6 months plus) where diabetes has then been diagnosed..leaves you with diabetes even after coming off the drug. Still..time will tell. I would add - I new diabetes was risk in renal transplant patients because of this drug, and I'd rather have diabetes than have to rely on dialysis. Interestingly many clinics are now stopping the use of it in such patients - relying instead on other drugs. Sorry - I do go on and on and on....

Not going on and on at all Paul, I think your experience and thoughts could be helpful to someone going through the same issue. One line stood out to me "I'd rather have diabetes than have to rely on dialysis" and although my health probs are different, I feel the same way. I don't know if my long term use of Prednisolone contributed to my diabetes T2 appearing, I guess it's a possibility, I never really thought about it. But it made the difference between life and death for me so in reality, there was no contest. I think this is the same for many of us, and for those who don't rely on it as a life saving measure, it can be difficult to understand why we would willingly take a med with so many possible harmful side effects. I think those that have to live with a long term condition get it completely.

 

[Lou73]

Hi. I have been taking Prednisolone for almost 3 years due to Rheumatoid Arthritis - and have previously taken due to my asthma. I was diagnosed with diabetes almost 2 years ago - steroid induced. However, I also have a family history of diabetes and had gestational diabetes - so the steroids may have caused me to develop it earlier. I have to take the steroids if I want to be able to move - until we find a medication that works for me. I do need to have some quality of life, and to be able to continue working and look after my family. So I understand ladybird64 when you say that people find it difficult to understand why we take these meds with so many possible harmful side effects. Long term conditions suck - but you do what you need to do to get on with life. I now use insulin, which so many people feel is the wrong way to go - but if it helps me get on with my life I'm happy control my diabetes this week. None of the oral medications worked for me.

 

[Sean01]

!!!! I had to look this up. I have very mild asthma and don't use an inhaler or any other medical treatment from one day to the next - but I do get an attack when the damp weather comes along. Normally I can deal with it, but this year I caught a bug and had to ho to A&E. They prescribed 40mg of Prednisolone for 4 days after putting me on a nubulizer for about 20 minutes. I was off them by the start of the new year. I had no idea there could be complications like the ones I'm reading about. I need to learn a lot more like how to turn things round to get off the long term meds.

 

[pleinster]

!!!! I had to look this up. I have very mild asthma and don't use an inhaler or any other medical treatment from one day to the next - but I do get an attack when the damp weather comes along. Normally I can deal with it, but this year I caught a bug and had to ho to A&E. They prescribed 40mg of Prednisolone for 4 days after putting me on a nubulizer for about 20 minutes. I was off them by the start of the new year. I had no idea there could be complications like the ones I'm reading about. I need to learn a lot more like how to turn things round to get off the long term meds.

Hi Sean..I think it's a lot to do with how long you are on this kind of drug. I was (by more than one renal doctor) told prior to transplant it was risk..and (by others since) that where someone might be on steroids like this for a short period (2 months of less) any increase to blood sugars may well reverse when the drug treatment is stopped, but if Type 2 develops and the treatment is longer..it's more likely you have to consider yourself diabetic and act accordingly. So..how long you been on it, and maybe speak to your doctor about whether or not its time to cut the dosage or come off altogether..maybe its done its job. I have no doubt it's a useful drug..but I have also no doubt that prednisolone increases blood sugar...and I still get spike from it every day.

 

[Sean01]

Hi Sean..I think it's a lot to do with how long you are on this kind of drug. I was (by more than one renal doctor) told prior to transplant it was risk..and (by others since) that where someone might be on steroids like this for a short period (2 months of less) any increase to blood sugars may well reverse when the drug treatment is stopped, but if Type 2 develops and the treatment is longer..it's more likely you have to consider yourself diabetic and act accordingly. So..how long you been on it, and maybe speak to your doctor about whether or not its time to cut the dosage or come off altogether..maybe its done its job. I have no doubt it's a useful drug..but I have also no doubt that prednisolone increases blood sugar...and I still get spike from it every day.

Good luck with the low carb and keep at it. Just goes to show, there's some stuff out there which does you good on the one hand but side effects which catch you out. My stint with prednisolone was only 4 days - in the past I've used becotide and ventalin - but I haven't used becotide for at least 20 years and ventalin a few times a year - if I get a bit wheezy.

 

[Jackie2406]

Hi @Jackie2406 how long have you been on prednisolone in total? If it was a long term treatment then you may be going through a pred adjustment withdrawal 30 to 15 since new year sounds a bit quick to me (for a long term pred user). Sue x

 

[Jackie2406]

Id been on it since the beginning of December. I was advised to wean down quite quickly to try & avoid complications (ironic) I have UCTD an auto immune type illness. A flare of that makes me not want to get out of bed & prednisolone is a last resort for me. id gone down to 10mg when on Boxing Day I got a winter vomiting bug. 3 days later I had thirst dry mouth blurry vision dry eyes. I contacted my GP (telephone consultation) & despite my protest -I'm a long lived nurse- she insisted it was the UCTD causing the symptoms. She told me to go back up to 30mg for a few days. I wish id followed my own instincts because my glucose level was in the high 20s when I bought a meter. Ive gone down do 10 mg today But for some reason my glucose levels have been high.

 

[Jackie2406]

I'm following a low GI/GL diet

 

[pleinster]

Id been on it since the beginning of December. I was advised to wean down quite quickly to try & avoid complications (ironic) I have UCTD an auto immune type illness. A flare of that makes me not want to get out of bed & prednisolone is a last resort for me. id gone down to 10mg when on Boxing Day I got a winter vomiting bug. 3 days later I had thirst dry mouth blurry vision dry eyes. I contacted my GP (telephone consultation) & despite my protest -I'm a long lived nurse- she insisted it was the UCTD causing the symptoms. She told me to go back up to 30mg for a few days. I wish id followed my own instincts because my glucose level was in the high 20s when I bought a meter. Ive gone down do 10 mg today But for some reason my glucose levels have been high.

I'd say the "for some reason" is...prednisolone. See how it goes on the lower dose...I'm still getting spikes on 5mg (admittedly a little lower than prior to being more in control of my diet. There is very little doubt the drug increases BS, and I would ask about alternative meds in your situation, or consider coping without if possible.

 

[Jackie2406]

Thank you -I agree, & hope to be off them pretty soon! I see you are on Mycophenolate Motefil -me too for UCTD. It was working well until last Autumn

 

[pleinster]

Thank you -I agree, & hope to be off them pretty soon! I see you are on Mycophenolate Motefil -me too for UCTD. It was working well until last Autumn

What was the problem with MMF? I was warned that it can cause really bad stomach problems...but as my digestive system likes to take the p@ss out of me or a regular basis anyway, it's hard to blame the MMF alone. I take 1 mg twice daily as part of my anti-rejection treatment, and was told that spreading it out to 4 pills taken individually over the day can make a big difference..or there's another similar, gentler alternative.

 

[Nnora]

Just one small remark, Metformin might not work well for you, as your condition is steroid-induced, and not "regular T2D". Please read the article published on: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4112077/#R1. My advice is to test frequently your BG, and focus on physical activity and diet: exclude all high carbohydrate food (for example- replace bread with cooked soya beans) and avoid all saturated fats, etc.. Good luck!

 

[MarcoRiveira]

Just one small remark, Metformin might not work well for you, as your condition is steroid-induced, and not "regular T2D". Please read the article published on: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4112077/#R1. My advice is to test frequently your BG, and focus on physical activity and diet: exclude all high carbohydrate food (for example- replace bread with cooked soya beans) and avoid all saturated fats, etc.. Good luck!

Very interesting, thanks for the link ! I was also thinking it was the prednisolones I have been taking on and off for prostatitis pain and long-term cough that contributed to my diabetes diagnosis. I don't take prednisolone anymore, just NSAIDs when needed, rarely now.

I am not sure too if Metformin really works effectively for me. Gliclazide on the other hand 100% works (I eat lunch and dinner regularly). I have to do more tests with Metformin.

Does this mean SIDM is easier to reverse than non-SIDM ?