Diabetes and rheumatoid arthritis

[Owl123]

Hi, I have diabetes and rheumatoid arthritis . The RA is under control with Enbrel and I have been place on insulin for the diabetes. I have so far tried 4 types of insulin but each one caused a flare-up of the RA. (rheumatoid arthritis)

It took over a year to get the RA under control and manageable (over 3 years ago and has been reasonably stable, the odd flare up but that's to be expected), so don't want to change what's working for me in that front.

I (me and the diabetic team) cannot seem to be able to find anything at the moment which will help the diabetes. some of the insulin has made it better but still caused a flare up, and also made it worse plus flare up.

I have been told that they have not seen this happen before

Is there any information out there which might help me or do I have to keep on going through the list of different types of insulin?

 

[Ralph-YK]

Welcome to the forum Owl123.
Do you know your result to a HbA1c test. (Blood taken from your arm. It shows an average from the last 8-12 weeks.)
Have you been given a meter, and test strips on prescription?

 

[Thebearcametoo]

It’s really difficult to balance different chronic illnesses so I sympathise. Are you on any other meds for your diabetes besides insulin?

 

[rebrascora]

Hi
Have you tried making dietary changes to control your diabetes? ie eating a low carbohydrate diet. This is usually combined with eating more dietary fat. Both aspects might benefit your arthritis as well as diabetes. I know my joint pain diminished dramatically when I changed my diet.

Low carb eating means cutting out all the obvious sugar and sweet stuff but also significantly reducing your consumption of starchy foods like bread, pasta, rice (even the healthy wholemeal/grain varieties), potatoes, breakfast cereal (including porridge in some cases) and fruit. That may sound pretty drastic but once you get used to it and you increase your fat intake, it is an enjoyable way to eat and can lead to weight loss. Many of us enjoy our low carb higher fat diet so much that we would not want to go back to our old way of eating and it has helped to stabilise our Blood Glucose levels and for me, I haven't had a migraine since I started, which was a chronic and debilitating problem for the past 10+years. There is a growing wave of scientific interest in eating a low carb, higher fat diet and many believe that the growing diabetes epidemic may in part be down to the low fat dietary advice that we have been bombarded with our whole lives. It even looks like the research 70 years ago which indicated a link between dietary fat and cardio vascular disease was flawed, so the whole low fat advice may even have lead to us being less healthy instead of more.

It is something to consider anyway, if you haven't tried it. It does take a lot of getting your head around but after a month or two of learning what to buy and how to cook it, it becomes your new normal.

 

[Owl123]

Welcome to the forum Owl123.
Do you know your result to a HbA1c test. (Blood taken from your arm. It shows an average from the last 8-12 weeks.)
Have you been given a meter, and test strips on prescription?

 

[Owl123]

Hi, my HbA1c levels last time they were checked was about 100
I do have a meter, before the last change of insulin it was about 11-12 in the morning and about 15-18 at night. After the last change of insulin its about 15 in the morning and over 20 at night, not good I know.
Tom

 

[trophywench]

Owl - have you been diagnosed with Type 1 diabetes or another Type?

Knowing that various foods can aggravate RA (eg tomatoes, strawberries and citrus fruit) what dietary changes have you needed to make firstly for the RA and secondly regarding the diabetes?

 

[Owl123]

Owl - have you been diagnosed with Type 1 diabetes or another Type?

Knowing that various foods can aggravate RA (eg tomatoes, strawberries and citrus fruit) what dietary changes have you needed to make firstly for the RA and secondly regarding the diabetes?

Hi, I have been diagnosed as having type 2, RA was under control before taking metformin but after 4 tablets had a flare of the RA. got it back under control and then tried insulin (4 different types) with the same results.

 

[Owl123]

It’s really difficult to balance different chronic illnesses so I sympathise. Are you on any other meds for your diabetes besides insulin?

Hi I have had to stop the insulin to get the RA back under control, i am on no other meds for Diabetes at the moment, waiting to hear back from diabetic nurse as to next step.

 

[rebrascora]

Can you give us an idea of what you normally eat in a day ie what you have for breakfast, lunch and tea/dinner. We might be able to suggest ways in which you could modify your diet to improve your BG without medication.

 

[Owl123]

We are just in the middle of trying to change the diet, but generally it's a bowl of cereals in the morning, 2 slices of bread sandwich lunch time, (ham, cheese, egg, peanut butter or something similar) maybe bag of crisps, tea time, it varies but meat and veg. sometimes fish. I am not a big veg eater,
I also don't snack during the day, but sometime when trying to get flare up sorted, I have found that dark choc helps me, so have that as required.

 

[rebrascora]

Breakfast cereals are full of sugar and starches so not an ideal start to the day for a diabetic.Have you considered an omelette for breakfast with whatever filling you fancy (ham, mushrooms, cheese, onion etc), perhaps served with a salad and coleslaw (but no bread) or bacon, eggs, mushrooms tomatoes and sausages.... again without bread or toast though.
Even just swapping that one meal would make a big difference.
Then you could try low carb bread (Available in most supermarkets) to have with your lunchtime sandwich and a packet of nuts or even occasionally pork scratchings if you like them, instead of crisps, or olives are a great low carb snack (again if you like them).
A square or two of 70% dark chocolate or higher % cocoa is fine every once in a while but best to steer clear of milk chocolate.
Cooking vegetables in butter or with cream or cheese makes them so much more enjoyable particularly cabbage or kale or spinach or cauliflower which is a bit of a miracle veg for us diabetics as it is low carb and can be cooked and mashed with cream cheese and a spoon of mustard to replace potato mash with bangers or any other meat for that matter or used to top a cottage pie etc or it can be finely chopped and used to replace rice or couscous in a recipe. I can happily eat a gammon steak and a massive serving of cauliflower cheese without ever missing having spuds on my plate and that is an easy low carb meal.
Hopefully that will give you some ideas of how you can make simple changes and that they don't all have to be unpleasant swaps where you feel deprived. Who doesn't love a cooked breakfast after all! And coffee with cream instead of sugar is a breakfast luxury I wouldn't want to give up now that I have broken my sugar addiction.

 

[Drummer]

Did no one ever explain that diabetes is an inability to deal with carbohydrates, which are sugars and starches?
I would not be surprised to hear that is news to you - hence you eating potato, bread and breakfast cereal.
The meat, fish, eggs and cheese are all fine, and form the basis of low carb eating, but I find that legumes, peas and beans are not something I can cope with, so I avoid peanuts.

 

[rebrascora]

so I avoid peanuts

Other proper nuts like brazils, walnuts and hazel nuts as well as almonds are all pretty low carb though and suitable as snacks.

 

[Ralph-YK]

Breakfast cereals are full of sugar

Those without sugar affect my BG as much as those with sugar. Both give a rise between five and six.

before the last change of insulin it was about 11-12 in the morning and about 15-18 at night. After the last change of insulin its about 15 in the morning and over 20 at night, not good I know.

Is that before or after food?
Test before and 1-2 hours after eating. This will show you what affect food has on your BG, along with any changes you make.
I suggest you keep a food diary, along with a record of your levels. After a couple of weeks you should start to see a pattern.

Insulin: I believe the usual procedure is to start with a conservative dose. Then adjust it when they see the affect on your BG. Has changing the type of insulin, and the problems with the RA prevented this?

 

[Owl123]

Breakfast cereals are full of sugar and starches so not an ideal start to the day for a diabetic.Have you considered an omelette for breakfast with whatever filling you fancy (ham, mushrooms, cheese, onion etc), perhaps served with a salad and coleslaw (but no bread) or bacon, eggs, mushrooms tomatoes and sausages.... again without bread or toast though.
Even just swapping that one meal would make a big difference.
Then you could try low carb bread (Available in most supermarkets) to have with your lunchtime sandwich and a packet of nuts or even occasionally pork scratchings if you like them, instead of crisps, or olives are a great low carb snack (again if you like them).
A square or two of 70% dark chocolate or higher % cocoa is fine every once in a while but best to steer clear of milk chocolate.
Cooking vegetables in butter or with cream or cheese makes them so much more enjoyable particularly cabbage or kale or spinach or cauliflower which is a bit of a miracle veg for us diabetics as it is low carb and can be cooked and mashed with cream cheese and a spoon of mustard to replace potato mash with bangers or any other meat for that matter or used to top a cottage pie etc or it can be finely chopped and used to replace rice or couscous in a recipe. I can happily eat a gammon steak and a massive serving of cauliflower cheese without ever missing having spuds on my plate and that is an easy low carb meal.
Hopefully that will give you some ideas of how you can make simple changes and that they don't all have to be unpleasant swaps where you feel deprived. Who doesn't love a cooked breakfast after all! And coffee with cream instead of sugar is a breakfast luxury I wouldn't want to give up now that I have broken my sugar addiction.

Thanks for your reply, but I am a fussy eater, I like colli and cheese but not together, as for the bag of nuts, I would love to but have other complications which rule them out.
As mentioned going for the diet change and will see how that works out, was trying to find out if others have had problems with mixing meds for diabetes and RA as the specialists have not seen this problem before.

 

[Owl123]

Those without sugar affect my BG as much as those with sugar. Both give a rise between five and six.

Is that before or after food?
Test before and 1-2 hours after eating. This will show you what affect food has on your BG, along with any changes you make.
I suggest you keep a food diary, along with a record of your levels. After a couple of weeks you should start to see a pattern.

Insulin: I believe the usual procedure is to start with a conservative dose. Then adjust it when they see the affect on your BG. Has changing the type of insulin, and the problems with the RA prevented this?

Hi, at the moment just doing first thing in morning when I wake up and last thing at night before going to bed.
my BG has changed after each different type of med tried, some making no difference at all, one made it go higher, (don't know how as on the same diet as before) but each one tried caused a flare of the RA. Swollen hands fingers and generally pain all over which got better after stopping the insulin etc.

Just trying to gain any help with reference to the mixing of meds for the RA and diabetes.

 

[Owl123]

Did no one ever explain that diabetes is an inability to deal with carbohydrates, which are sugars and starches?
I would not be surprised to hear that is news to you - hence you eating potato, bread and breakfast cereal.
The meat, fish, eggs and cheese are all fine, and form the basis of low carb eating, but I find that legumes, peas and beans are not something I can cope with, so I avoid peanuts.

No it is not news to me at all, but when you are trying to deal with 2 problems, I need something which is stable so I can see how things are being affected and changed.

 

[grovesy]

I have found in the past that sometimes adjusting potion size can help.

 

[Owl123]

I have found in the past that sometimes adjusting potion size can help.

I agree it does help, but you can only adjust it so much. I have lost over 4st in the past 18 months without trying while eating the same size portions as before so I need to be careful.