Prednisolone and its immediate impact on blood sugars

MargaretR said:

Me too! I’ve just been mentally composing a post asking for advice about my soaring blood sugar levels, and Pipp and Kiteslady have just reminded me of the most likely reason. I’ve normally been getting bloods of between 4 and 5 first thing in the morning, and this will have dropped to 4 before lunch.. I’ve had a difficult time since February with a knee transplant which got infected, and still hasn’t healed properly, so my BG has been creeping up because of the infection(s) and multiple antibiotics,, plus hospital food. I started on prednisolone 10 years ago for polymyalgia rheumatica, and it’s that that triggered the Type 2. My PMR has changed to rheumatoid arthritis, so I’m now on methotrexate, but still taking 10 mg of prednisone. Yesterday I thought an RA flare was coming on as I couldn’t use my hands, so I took an extra 10 mg of pred as advised by the rheumatologist in order to nip it in the blood. That at least has worked! Then late yesterday my dog jumped over my legs to get to the window to see the Amazon man, and ripped the skin on my leg (not the one with the new knee) tearing back a flap about the shape and size of an envelope flap. Off to A and E. And I forgot to check my blood sugar.

When I took it this morning I was in the 7 s and it has continued to rise all day, despite my meals being tried and tested ones. It’s currently 11.1, and I haven’t eaten since lunch.

I was about to post asking if people thought it was
A). The heat
B). The trauma of skin being torn off ( prednisolone is notorious for causing fragile skin)
C). A possible infection starting.

The 2 previous posters have reminded me that the likely cause is the extra prednisolone I took yesterday

Many thanks for reminding me.

Margaret

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Pipp said:

To be absolutely clear, I would prioritise the breathing difficulty every time, but reassess as breathing improved.

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pleinster said:

Hi. I am sure many of you will be aware that steroids can cause dramatic increases in blood sugar levels, and that long term treatment with particular steroids can actually trigger or directly cause Type 2. I got diabetes after taking prednisolone for over three months as part of my anti-rejection treatment following a renal transplant (due to a hereditary condition). Most people will experience an increased level with this drug but things should drop back down to normal if the treatment is under 30 days or so. Most transplant patients will be on it for life though the dose can be dramatically reduced. I was warned by all my doctors pre-op that it was a common consequence of the transplant treatment..and I was more than happy to take the risk..indeed, I would do it again and would always take having Type 2 over total renal failure..of course. Some uninformed people still think Type 2 isn't so much caused by steroids as it is triggered. Initially, my doctors (a number of them) referred to to it as Steroid Induced Diabetes but all of them are now clear, as is the diabetic consultant I see, that long term treatment with this particular steroid CAUSED my diabetes. Now, after a great deal of effort, testing, recording, avoiding carbs and getting docs to cut my prednisolone down to a minimum, my levels have been pretty normal (so long as I stick to my approach), and my last HbA1c was 41 (barely diabetic), averaging meter readings under 7mmols. I have not been on any meds for diabetes for at about 18 months (by choice). Problem is, people on anti rejection drugs have their immune systems suppressed to minimise the body attacking the intruding new organ..and as a consequence they are open to more infections than the average person. One particular infection I just got can cause pain from inflammation in a rather sensitive place...and doctors don't want renal transplant patients to take anti-inflammatory drugs like ibuprofen or voltarol ..soo...they up the prednisolone for a period as pain relief while the anti-biotics hopefully do the job. ANYWAY...point is...three hours after the increased dose my levels went up to about 14mmols, and have not been much below that over the last two days regardless of zero carbs. I am not just writing this to **** off prednisolone (it has some very good uses), but to inform...I worked very very hard to get things under control only to have to start again when I come off this (as it doesn't just drop down right away when you stop). My point is that if you don't have to take this particular steroid...don't. Many transplant centres are not avoiding it completely. I am not saying stop taking it..but discuss alternatives with your doctors. I think I might just try and bear the pain rather than risk further damage (however temporary).

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Pipp said:

why did you need the prednisone, @Ziggy2017 ? Did you have a lung condition? You are not saying the steroid meds was the cause of you needing the lung transplant are you?

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MargaretR said:

Thanks Pipp

Yes, in terms of priorities, my skin tear, and the unsealed wound on the other leg have got to take priority over what I hope is a temporary rise in blood sugar.
On a brighter note, after hardly eating anything yesterday I was down to 5.6. This is a bit high for me, but much better than yesterday.

So I’ll have half a breakfast and the go to the hospital for a check on the wound and dressing.

I hope you are in the bit of the country which is getting a bit cooler today.

Margaret

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Pipp said:

Thank you for clarifying @Ziggy2017 . Just didn't want folks to be alarmed if they thought the use of steroids had caused the problem that made your transplant necessary. You have certainly had a lot to contend with.
Short term steroid use is sometimes a necessary risk for some of us with allergic conditions. I choose to accept the prescription only when I struggle with chest infection that causes severe breathing difficulties. We each have to take advice from doctors and apply as relevant.

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