Type 2 Diabetic Diagnosed with Polymyalgia Rheumatica

[Shecar66]

Evening,

I am a Type 2 diabetic of 25+ years and have very recently been diagnosed with PMR, treatment is Steroids, Prednisolone.
I am currently in my second week @ 30mg daily - this has had a significant effect on my blood sugars, fasting being around 9mmol/L and going up to between 20-24mmol/L during the day, with night time, (pre bed), only just dropping to between 15.5-18.5mmol/L.

I have now cut out all breads, pasta, rice, potatoes, most fruits and the readings have dropped to the lower range shown above, but obviously these are still high.

I am seeing my Dr for the weekly follow up next Tuesday, but wondered, in the meantime if there was any advice out there from others in the same situation.

To clarify I take Metformin @ 1000mg twice daily and Alogliptin @ 25mg once daily

Again any help, further advice or experiences would be gratefully received.

 

[Inka]

Welcome @Shecar66 🙂 Yes, steroids push blood sugar up. Are you going to be on them for a long time or is your course fairly short? If it’s a long time and you’ve already cut your carbs right down, you might need additional medication to help control your blood sugar.

I seem to remember someone here mentioning PMR but I can’t remember who. I’ll edit this post if I do remember.

 

[rebrascora]

Hi and welcome.

Just doing a quick calculation, it looks like you were diagnosed diabetic when you were 32yrs old. Can you remember how you came to be diagnosed? ie. were you symptomatic and if so which symptoms or was it identified via a routine blood test? The reason I ask is that PMR is autoimmune and so is Type 1 diabetes which can have a slow onset in adults referred to as LADA (Latent Autoimmune Diabetes in Adults). LADA can often present as Type 2 and even respond to Type 2 medication in the early stages, but perhaps the steroids have put your remaining insulin producing beta cells under too much strain and you are now at the stage that you need insulin because you are unable to produce enough yourself.
Autoimmune conditions have a tendency to develop in the same body (perhaps a genetic predisposition) so just wondering if you might have autoimmune diabetes (Type 1) rather than metabolic (Type 2).
You have my sympathies re PMR. My sister developed it not long after I developed Type 1 diabetes and some days it is just painful breathing for her. Interestingly we both developed them at menopause. I am hoping that we have shared our genetic "share" of autoimmune conditions and we stick at just one each. Also hoping that the PMR disappears after a few years as I believe it can. Unfortunately the diabetes is with me for life but I will take that over PMR. Really sorry that you have both to contend with but I would be asking for insulin with levels that high, or at the very least a C-peptide test which will show how much insulin your own pancreas is able to produce. .

 

[Shecar66]

Welcome @Shecar66 🙂 Yes, steroids push blood sugar up. Are you going to be on them for a long time or is your course fairly short? If it’s a long time and you’ve already cut your carbs right down, you might need additional medication to help control your blood sugar.

I seem to remember someone here mentioning PMR but I can’t remember who. I’ll edit this post if I do remember.

It has been suggested a two year run - so, bleak

 

[Shecar66]

Hi and welcome.

Just doing a quick calculation, it looks like you were diagnosed diabetic when you were 32yrs old. Can you remember how you came to be diagnosed? ie. were you symptomatic and if so which symptoms or was it identified via a routine blood test? The reason I ask is that PMR is autoimmune and so is Type 1 diabetes which can have a slow onset in adults referred to as LADA (Latent Autoimmune Diabetes in Adults). LADA can often present as Type 2 and even respond to Type 2 medication in the early stages, but perhaps the steroids have put your remaining insulin producing beta cells under too much strain and you are now at the stage that you need insulin because you are unable to produce enough yourself.
Autoimmune conditions have a tendency to develop in the same body (perhaps a genetic predisposition) so just wondering if you might have autoimmune diabetes (Type 1) rather than metabolic (Type 2).
You have my sympathies re PMR. My sister developed it not long after I developed Type 1 diabetes and some days it is just painful breathing for her. Interestingly we both developed them at menopause. I am hoping that we have shared our genetic "share" of autoimmune conditions and we stick at just one each. Also hoping that the PMR disappears after a few years as I believe it can. Unfortunately the diabetes is with me for life but I will take that over PMR. Really sorry that you have both to contend with but I would be asking for insulin with levels that high, or at the very least a C-peptide test which will show how much insulin your own pancreas is able to produce. .

Evening, thank you for that reply, It was picked up on a routine blood test and I managed with diet control for 8-9 years - in my early 40's I was put onto Metformin, then it was changed about 10 years ago to a 'combined' Medication - Xigduo - basically designed to promote excess sugar leaving the body through the kidneys/urination - no good for me, after years of progressively worsening repetitive UTI's, (2 years ago culminating in a wonderful kidney infection and the resulting couple of successive hospital stays with Sepsis), I was put back onto Metformin with the Alogliptin. I'm having bloods on Monday and a follow up with the doctor on Tuesday - I'll certainly be asking the question - thank you

 

[Inka]

It has been suggested a two year run - so, bleak

Then I’d think it would be to your benefit to maybe have insulin. This should be a massive help in controlling your blood sugars, and once they’re controlled, you’ll feel better in yourself. High sugars are horrible. Don’t be nervous about the possibility of insulin. The injection pens are convenient and the needles are tiny and very thin.

 

[everydayupsanddowns]

Sorry to hear about the impact steroids have had on your gkucose levels @Shecar66

It does sound as if some additional medication would be helpful. Hope your Dr comes up with a helpful suggestion. And as @Inka says, it might be worth letting them know you’d be happy to consider insulin while the steroids are wreaking their havoc?

 

[Shecar66]

hen I’d think it would be to your benefit to maybe have insulin. This should be a massive help in controlling your blood sugars, and once they’re controlled, you’ll feel better in yourself. High sugars are horrible. Don’t be nervous about the possibility of insulin. The injection pens are convenient and the needles are tiny and very thin.

Hi Inka, Not bothered by needles, more so by having raised levels and a knock you off your feet fatigue that I can't shake off - and, of course, the fact that I have pretty much brought this on myself - sometimes not great adherence to the BS levels. No turning the clock back now! Had to fight for the last two years seeing junior doctors who insisted that my PMR was menopause - I started that fun ride 14 years ago! Luckily seen someone now that has listened and run all of the blood tests to diagnose PMR, dislike being on steroids but am so relieved at the almost pain free life they are giving me.

 

[everydayupsanddowns]

dislike being on steroids but am so relieved at the almost pain free life they are giving me.

Ah that’s great to hear! I had just realised I‘d forgotten to ask if they were helping. So pleased you are finding them so effective - and amazing that you are almost pain free 🙂

 

[Shecar66]

Ah that’s great to hear! I had just realised I‘d forgotten to ask if they were helping. So pleased you are finding them so effective - and amazing that you are almost pain free 🙂

Thank you - just aches and tightness, bit restrictive in the mornings - but I'll take that anyday over the continued pain I had been experiencing - grateful for the diagnosis - now just a question of navigating treatment and balancing it with diabetic control, hence the post.