I was diagnosed with Polymyalgia Rheumatica in the autumn of last year. To begin with my blood sugar levels seem okay but though I am gradually reducing my steriod dose (currently 7 mg daily), my blood sugars have gone crazy and the diabetes nurse is suggesting I might need to start using insulin as my steriod use is also likely to be long term. Currently I am taking metformin, sitaglyptin and empagliflozin, which in combination with the prednisolone. Any advice would be welcome!
Steroids do mess with our glucose levels. Our livers dump glucose when they get a signal from our pituitary glands that we need it, that signal being corticosteroids. Usually due to stress, illness or waking. Alas, steroids like prednisolone, are pretty much the same compound, so you're on something that keeps telling your liver to up the glucose output. When that's temporary it can take weeks or months for your numbers to return to normal, but sometimes it's just something that's going to be a permanent fixture. The medication isn't exactly what you call optional if you want to be as pain free and mobile as possible. So you control what you can: your diet, your other medication, and yes, sometimes that does mean having to go on insulin. There's no shame in having to switch to more impactful diabetes meds just because you need to be able to function: quality of life matters. You just control what you can, and let go of what you can't.
@Mark Rawlinson suggested speaking with your pharmacist, which is a good idea, as well as keeping the lines of communication open with your diabetes nurse. You might also want to use a CGM so you know what your blood sugar levels are doing now that you're on prednisolone. It might help your nurse and you decide on the best course of action, going forward, and faster than waiting another 3 months for a new HbA1c.
Hang in there eh. There's more people on here who need steroids for other conditions, and often with some extra tweaking, they do well. It's not impossible, just a little more complicated.
Hugs,
Jo