Type 2 and Polymyalgia Rheumatica

[Koalajane]

I have a problem. I am type 2 in remission and suffering with macular oedema. My opthamologist says it has worsened and it is due to the sugar spikes from my prednisolone that I take for Polymyalgia Rheumatica. She says I need a diabetic review.
My hba1c is 40 but about 3 hours after taking the prednisolone my sugars spike to about 8 for about 3 to 4 hours.
My problem is should I reduce my steroids even though this will cause pain or should I try to not have my sugars so low ( in the 5s ) the rest of the time so the spikes will not be as sharp. Any thoughts

 

[kitedoc]

As a diabetic (T!D), not as medical opinion or advice:
The best thought @Koalajane is to see your endo. You have been prescribe steroids for a good reason. Given their potential side-effects vs benefit I am sure your doctor will be endevouring to give you whatever is the minimal but effective dose.
see mayoclinic.org - steroids
Your endo can help you to find whatever is the best diabetes treatment to keep your BSL in the best possible range.
Looking up mayoclinic.org Polymyalgia Rheumatica will give you the basics of the condition. And note that some people also develop the eye condition related to temporal arteritis or Giant Call Arteritis which can affect vision.
The other consideration is that steroids can exacerbate any underlying infection and very very occasionally people have a dormant form of TB which can be awakened by steroids. see https://dxo.doi.org/10.1.36/bjo.82.6.704
Of course your doctor will have thought about all these things and discussed them with you in consideration of prescribing your steroids !!!
Finally long term steroids can affect bone strength and your doctor not doubt has alerted you to that and the best way to prevent problems.
Best Wishes

 

[Koalajane]

My doctor put me on steroids before type 2 diagnosis. I don't have an endo just a g.p.
My doctor warned me about my bone density and a scan showed I have very mild osteopenia so just take calcium and vit d3 for that

 

[kitedoc]

Has your doctor checked you for secondary causes of osteopenia?
see mayoclinic.org - osteoporosis.

 

[DCUKMod]

My doctor put me on steroids before type 2 diagnosis. I don't have an endo just a g.p.
My doctor warned me about my bone density and a scan showed I have very mild osteopenia so just take calcium and vit d3 for that

Koalajane - Do you take K2 with your D3? It's an important add on, as it helps it work better. There are various threads on the forum takling about Vit D supplements, as even without osteopaenia or osteoporisis there are great many who are deficient. It's an important viatmin for our overall health.

 

[Koalajane]

Yes I take k2

 

[Koalajane]

Has your doctor checked you for secondary causes of osteopenia?
see mayoclinic.org - osteoporosis.

I think any secondary cause of osteopenia would be age!

 

[kitedoc]

If you read the list you will see that thwere are amny causes of osteopenia and osteoporosis.
I am not sure that it is safe to assume only one cause even if the GP (being perhaps casual or a bit lazy) thinks so.

 

[Pinkorchid]

Yes my husband has had Polymyalgia and takes steroids. He was diagnosed with T2 after he developed the Polymyalgia the doctor said probably caused by the steroids his levels at diagnosis were only just over 7 so not very high . He is now in the process of reducing the dose each month to a maintenance level that keeps the pain at bay. They do not seem to affect his blood glucose levels to much as they have always been good his last HbA1c was 37

 

[ivan 2]

I was given steroids for myasthenia gravis (already had diabetes 2).
My endo made a plan.
I check my blood sugar before and after meals (i.e. 6 times a day) and then insulin doses are increased depending on blood glucose. I will visit my endo every 10 days with blood glucose results as described above.