Medication concerns

[GT1947]

I had a routine blood test last week and my GP advises me that I am borderline prediabetic. Her advice was to exercise, keep my weight down, avoid sugar in my diet and have repeat blood tests every 12 months.

Being the inquisitive person that I am, I spent some time gooogling prediabetic to find out more about it.

One thing that immediately struck me, is that certain prescription meds can cause prediabetes, and of the meds listed, I am taking three.

Two of these are statins and beta blockers which I have been taking for many years due to heart problems. I expect to be taking these for life.

The third medication is the one which concerns me. This is corticosteroids. Over two years ago, I was prescribed a flucatisone nasal spray to treat nasal and sinus problems. I was referred to a ENT specialist who advised me that I needed sinus surgery. This was originally scheduled for August 2019. However it was delayed for various reasons and of course we all know what happened in 2020!

I was advised to continue using the spray until I had the surgery, but at the time nobody expected it to be over two years.

As flucatisone is a steroid, I asked my GP if I should discontinue this medication as it may be causing the prediabetes. However I was advised that the steroid content was low and therefore this was unlikely and I should continue with the nasal spray.

However having spent some time researching the Internet, there seems to be lots of articles about steroids causing prediabetes, so it does worry me.

I'm tempted to just stop using the nasal spray now. To be honest it doesn't really help my sinus condition, so I'm not too concerned about it.

The good new is that I have now had a pre op assessment for my surgery, so hopefully it may not be too long.

 

[Pipp]

Hello @GT1947 and welcome.
Sorry you haven’t had a response before now. Perhaps members are concerned as we are not allowed to advise on changing prescribed medications.

I do understand your concerns though. I have had to use steroid nasal sprays for over 10 years as I have lots of allergies. I also have steroid inhalers. These medications do not seem to have an adverse effect on my blood glucose levels. However, if I have to take oral steroid medication following a bad allergic reaction, then I find blood glucose levels are out of control for weeks after.

You could find that monitoring your blood glucose levels yourself using a meter daily, would be reassuring. Pre-diabetes can lead to diabetes, but with the right dietary intervention, (reducing carbohydrates in diet) non-diabetes levels can be achieved.

Without wishing to alarm you, are you aware of literature regarding statins and beta blockers? These are often considered to have detrimental effect on blood glucose control.

As your doctor has advised remaining on the nasal medication until after surgery, and that surgery is imminent, you shouldn’t have too much longer needing the nasal steroid spray anyway.

Wish you luck with the surgery and good health.

 

[JoKalsbeek]

I had a routine blood test last week and my GP advises me that I am borderline prediabetic. Her advice was to exercise, keep my weight down, avoid sugar in my diet and have repeat blood tests every 12 months.

Being the inquisitive person that I am, I spent some time gooogling prediabetic to find out more about it.

One thing that immediately struck me, is that certain prescription meds can cause prediabetes, and of the meds listed, I am taking three.

Two of these are statins and beta blockers which I have been taking for many years due to heart problems. I expect to be taking these for life.

The third medication is the one which concerns me. This is corticosteroids. Over two years ago, I was prescribed a flucatisone nasal spray to treat nasal and sinus problems. I was referred to a ENT specialist who advised me that I needed sinus surgery. This was originally scheduled for August 2019. However it was delayed for various reasons and of course we all know what happened in 2020!

I was advised to continue using the spray until I had the surgery, but at the time nobody expected it to be over two years.

As flucatisone is a steroid, I asked my GP if I should discontinue this medication as it may be causing the prediabetes. However I was advised that the steroid content was low and therefore this was unlikely and I should continue with the nasal spray.

However having spent some time researching the Internet, there seems to be lots of articles about steroids causing prediabetes, so it does worry me.

I'm tempted to just stop using the nasal spray now. To be honest it doesn't really help my sinus condition, so I'm not too concerned about it.

The good new is that I have now had a pre op assessment for my surgery, so hopefully it may not be too long.

I use a steroid inhaler for my asthma, and it doesn't impact my bloodsugars at all. Similar to your nasal spray, it's a relatively small dose that is applied locally. Now, when I get a steroid shot in my hip of shoulder, that DOES up my blood sugars for about a week... But the dose is considerably larger. I think it's more the statins/blockers, really... I just had one, way back when, and you're taking two. The thing is, if you've had a cardiac event and you really do need them... Then they're not exactly optional.

What you can do however, is try and lower your blood glucose with things you can impact. Get yourself a meter so you can see what effect the measures you're taking are having, so you don't have to worry about it for 12 months eh. T2s (and prediabetics) can't process carbs well. So... Don't have them. Or at least, cut down. Besides the obvious sugars, you'll want to look at the starches in your diet. No more bread, cereals/oats/weetabix, spuds, rice, pasta, corn, underground veg, that sort of thing. That should bring your blood sugars back down to more normal levels and you wouldn't have to quit meds that you need for your heart-health.https://www.diabetes.co.uk/forum/blog-entry/the-nutritional-thingy.2330/ should help you along.

And, stick with the nasal spray for now. If you stop before the surgery things might flare, and after the sugery (assuming they're going to be removing the nasal turbinates?), you won't be able to breathe through your nose much for about a week, a week and a half anyway, and any flare might come and go without you especially noticing it as things heal and calm down. Been there, done that.

Good luck eh.
Jo