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Polymyalgia Rheumatica

M

Maz65

New Member
Relationship to Diabetes
Type 1
Hi there and happy New Year.
I wonder if I could ask if there is anyone on here that has PMR? I have had Type 1 diabetes for coming up 59 years and have just been started on steroids (prednisolone). I knew they would have an effect on my diabetes but currently, my control has gone out of the window. The DSN at my hospital is being very helpful and obviously, it’s still early days, but has anyone got any advice as to how to manage this, please?
Many thanks, Maz
 
Had to Google this condition as didn't know what PMR was.

If steroids use is going to be long term maybe ask your dsn if you would qualify for a pump, it's much easier to manage higher bg levels with a pump then it is with injections, know this from personal experience when illness strikes or during times like surgery & recuperation.
 
My sister developed PMR just after I developed Type 1.... we shared out the autoimmune conditions in our family!!.... so, whilst I have some understanding of the condition and you have my sympathies as it really stopped my sister in her tracks.... I don't have any knowledge of managing PMR with diabetes.

Are you on Methotrexate as well as steroids?
Which insulin(s) do you use and are you on MDI or a pump? Do you have a Libre or Dexcom sensor?
You will obviously need to titrate your doses to cope with the rise in BG from the steroids. What dose of Prednisolone are you on?
 
rebrascora said:
My sister developed PMR just after I developed Type 1.... we shared out the autoimmune conditions in our family!!.... so, whilst I have some understanding of the condition and you have my sympathies as it really stopped my sister in her tracks.... I don't have any knowledge of managing PMR with diabetes.

Are you on Methotrexate as well as steroids?
Which insulin(s) do you use and are you on MDI or a pump? Do you have a Libre or Dexcom sensor?
You will obviously need to titrate your doses to cope with the rise in BG from the steroids. What dose of Prednisolone are you on?
Click to expand...
Hi Barbara
Thank you for your reply. I’m on Humalog insulin and Tresiba and just on injections with a Libre sensor. I’m currently on 15mg prednisolone a day for 3 weeks (started on 6 Jan) and then reducing to 12.5mg for 3 weeks. My schedule lasts for 44 weeks and I don’t know what I would have done without my DSNs at hospital. Obviously insulin doses have been increased on this dose of steroids, but will be on a sliding scale as steroids decrease. I’m feeling much better but still issues first thing in the morning, but early days yet . After almost 59 years as type 1, I feel lucky that this is the first big hurdle I’ve had to leap
 
Good to hear you have supportive DSNs and that the steroids are taking the strain with the PMR. I believe you have to be quite careful when reducing the doses. My sister is down to about 3.5mg a day now about 6years after diagnosis, but reducing the dose at this level has to be done very, very slowly and carefully and it has taken over a year to come down from 5mg to where she is now otherwise she gets really bad flare up pains. She is pretty fit like me and otherwise healthy but there have been days when just breathing is painful and she can do very little and has to rest a lot in between, then she gets good spells where you can hardly tell there is anything wrong.

Do you mind me asking how much your insulin doses have been increased by and are those increases more or less keeping you in range?
 
rebrascora said:
Good to hear you have supportive DSNs and that the steroids are taking the strain with the PMR. I believe you have to be quite careful when reducing the doses. My sister is down to about 3.5mg a day now about 6years after diagnosis, but reducing the dose at this level has to be done very, very slowly and carefully and it has taken over a year to come down from 5mg to where she is now otherwise she gets really bad flare up pains. She is pretty fit like me and otherwise healthy but there have been days when just breathing is painful and she can do very little and has to rest a lot in between, then she gets good spells where you can hardly tell there is anything wrong.

Do you mind me asking how much your insulin doses have been increased by and are those increases more or less keeping you in range?
Click to expand...
My ratios have increased from 1 unit/9g at breakfast to 1 unit/7g, lunch from 1u/6g to 1u/3g and dinner 1u/8g to 1u/4g. My Tresiba has increased from 16 units to 19 units. Still some manoeuvring to be done and then all change in a couple of weeks. I’ve lost a bit of confidence after all these years in sorting my levels out, but early days yet and DSNs are a Godsend ☺️. I’m aware that you have to be very careful with steroid doses and at the moment am having blood tests every 3weeks to see how things are going. Thanks you for getting in touch and hope your sister has more good days than not
 
Thanks for that. Those rises in insulin doses are not as significant as I thought they might be.

Hope you don't find it too challenging coming down from both the steroids and the insulin. Do keep us posted with your progress and I hope your PMR attack is one of the shorter ones.
 
Sorry to hear about your polymyalgia @Maz65

Can’t add much to the suggestions that have been made, but wanted to wish you well, and hope the steroids keep working well, and that you find adjusted insulin doses that work well for you.

@Pumper_Sue needed to use steroids for some additional conditions too I think, but doesn’t seem to be posting on the forum quite so frequently these days.
 
In some ways I am not surprised about the control being difficult, having one ailment is enough which is where the steroid comes in, I hope you are feeling quite well on steroid and can focus on the diabetes.

Its winter and difficult to keep going with any kind of control routine at all, particularly when it snows, we might not realise how massively it changes what we do and when we do it. Let the snow clear and see if it enables better control.
 
Maz65 said:
Hi there and happy New Year.
I wonder if I could ask if there is anyone on here that has PMR? I have had Type 1 diabetes for coming up 59 years and have just been started on steroids (prednisolone). I knew they would have an effect on my diabetes but currently, my control has gone out of the window. The DSN at my hospital is being very helpful and obviously, it’s still early days, but has anyone got any advice as to how to manage this, please?
Many thanks, Maz
Click to expand...
Hi Maz,
work on your basal first and then your carb ratio.
The over all amount of insulin works out to be about 2units of insulin to 1 of pred.
If you want one ask for a pump so much easier to manage steroid doses 🙂
 
Sorry to hear of your new diagnosis. I do not have PMR, but I do have rheumatoid arthritis which has caused me to take prednisolone on a few occasions (most recently over Christmas).

I was on a short course 15mg for 1 week, 10 mg for 1 week and 5 mg for 1 week. Obviously we are all different but my insulin usage pretty much doubled, getting my basal dose right was a huge help, and then I worked to change my insulin to carb ratio. I’m fortunate to be on a pump so I have a basal profile set up that I switch on now each time I start a course of the steroids.

If you are comfortable changing your doses yourself then do so slowly until you reach the right amount for you. I find if really useful to keep notes of what I’ve tried and what worked.

I hope the steroids are helping you to feel better, i find them like magic for my RA and give me a few weeks of relief
 
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