I had/have Polymyalgia rheumatica for 10+ yrs. This is unusual as it often goes into remission after about 2yrs. I've had 2 bouts of giant cell Arteritis, and when that happens the only solution is to take very high doses of prednisolone (60/70 mg), or risk going blind overnight. Once you have gone up to that high a dose you have to come down very slowly, so it takes a long time.
This of course plays havoc with blood sugar levels, as the prednisolone is a trigger for diabetes 2. I escaped the Diabetes until about 4 years ago,when I was still on about 25 mg of prednisolone.
I went on low-carb more or less straight away, as I found this site a month before my DN appt came through. By the time she saw me I had already got an improvement to my BS levels, and had lost about a stone. (I had plenty to loose!)
If you are only on a short course, you can stop easily at the end of the course and the BS should go back to normal. While you are on them a low carb diet should help.
I did a lot of testing at the start of my Type 2, and found
1 the lower carb the better
2 there is (for me) a direct correlation between when I take the prednisolone, and the bs level rising. eg if I test in the morning before breakfast and get say 4.5, it will stay around that level until after lunch. Even if I don't have lunch it will start rising then. I take my prednisolone after breakfast, and I think that is when the BS starts rising.
3. I have 3 sizes of prednisolone, 5 mg, 2.5 mg and 1 mg. All 3 come as standard (uncoated, small white pills) But the 5mg and 2.5 mg also come as enteric slow release (small red pills). If I take the standard pills my BS rises earlier in the day. With the slow release I get a lower rise spread out for longer. The usual reason for prescribing the slow release ones is that they are less likely to cause stomach problems (ie stomach ulcers. We often use 'stomach' to mean general digestive system, but I'm using it here to mean the organ that is slightly above the waist where the food goes first). You may have to argue your case for the enteric coated tablets, as the uncoated are slightly cheaper. And again for a short course you probably don't need to bother.
It did occur to me to try splitting the dose of prednisolone into morning and evening, but the problem with that is that it can make you hyperactive and interfere with sleep. I read an article by someone who was prescribed a short course and was taking them at night. She found herself getting up in the middle of the night and scrubbing the kitchen floor.
I needed to test a lot to be able to pick out the patterns, but it was worth it. Also the DN I saw at the beginning gave me a meter and put strips on my prescription as she said that although they don't normally give them to Type 2's, mine was steroid induced, and it needed more testing to keep the BS under control.
About 2 years ago my rheumatologist decided the my Polymyalgia had morphed into rheumatoid arthritis, and put me on methotrexate with the aim of coming off prednisolone altogether. However, this isn't working quite to plan, and I'm still on 10 mg prednisolone, going up to 15mg if I get a flare of the rheumatoid arthritis.
I know our experiences are a bit different because of the type of diabetes we have, but I hope this helps a bit.
Margaret
