Polymyalgia and Diabetes

If you have PMR you will need steroids. They do have side effects, but that is no reason not to take them, I would be in a wheelchair on a one way trip to Switzerland without them. A lot of people have diabetes who take steroids, the diabetes just needs to be managed properly. What is your doctor suggesting you do, lie in bed in pain all day? I really do despair of some members of the medical profession sometimes. 

The prednisone has given me diabetes also.  I take metformin to control it.  My preference is to control the PMG with the steroids and marginally put up with the diabetes.

Good luck

Hi Jackie. You don't say whether you are T1 or T2 (or T1.5) so the PMR itself and the steroid dose will probably affect you differently from me. I have T1 diabetes and was simply warned by the rheumy and my GP that the steroid would raise my BG and could cause stability difficulties. Luckily, I am very well used to adjusting my insulin and carbs pretty much on the fly to keep my BGs within pretty tight limits without seeking permission from anyone. For me, the PMR pain had already stressed me so much, my insulin doses had gone up about 75% over normal anyway. The steroid got rid of the PMR pain and on steroid commencement my doses dropped pretty quickly to about 50% over normal and kept dropping back to normal as the steroid dose slowly fell. I'm off corticosteroids now (over 2 years, fingers crossed).

Basically, you should arrange to see your hospital diabetes doc and/or the Diabetes Support Nurse, or get referred to your local hospital diabetes department, to help you manage your diabetes with the PMR treatment. If you are T2 then the way you manage it may be somewhat different from my own, but it should not put you off getting the PMR treated. I suspect you will need adjustment to any diabetes meds. The diabetes doctors and the DSN are there to help you. Just make sure they do.

My PCP, nor my Rheumatologist mentioned diabetes. I've been on at least 10mg. since last July, is that considered a long time ? I've gained allot of weight, & now have high blood pressure, & started BP medication a few weeks ago. Always had good BP & never this overweight, my appetite is 10-times what it was pre-prednisone.

I am a type 2 diabetic and have been on insulin for about 7yrs now. Metformin just wasn't controlling my BSLs. Life is much easier on insulin. When I started prednisone for my GCA/PMR my BSLs went up but easy to keep on top of with insulin. Been on prednisone since January and BSLs have settled down. My HBa1c is still a nice 6.2, so all is good. Maybe you need to see your diabetes nurse and discuss your control.  May be time for insulin...which, for me, was a godsend!

I know nothing about diabetes, but I do know that if you have PMR, pred is the ONLY thing that will give you some relief from the symptoms. I also know that plenty of people here have both conditions - the pred does in fact bring diabetes on in some people.

If your currenty GP won't prescribe you pred you need to find another Dr or go back to your rheumy straight away. You can't just stop taking pred! If you have someone who helps you manage your diabetes then they will know how to deal with the interactions with pred and your other medications and conditions.

Your GP needs to find some compassion instead of scaring you. We all know Pred is "not good for us" Lord knows it's difficult enough for those of us who don't have other complications to deal with the side effects and the constant threat of what it "might" do to us in the long term. But there is no alternative for us. It's important to get the PMR inflammation under control. Next time he/she says that to you ask them to consult with your rheumy to discuss PMR. 

Jackie, no one wants to take preds, but we take them so we can continue having some degree of a good life. Unfortunately preds do have side effects and some of us are unlucky to suffer from some of them. You say you are type 2 diabetes, so you will knew w all about reducing carb intake. So, that is my advise, regulate your carb intake, and hopefully you'll see your blood sugars steadying. All the best, tina

Tell your GP that being in constant pain and unable to move is also not good for you or your diabetes.. Pred is the only answer at present to PMR and what is required is not uninformed comments of that sort but a bit of proactive management on his part.

You've already had some good advice from the others - and if it needs greater management than what you are already on you definitely need a referral to the diabetic clinic and experts bit a GP who obviously isn't interated.

I'd be inclined to look for a better GP to be honest if that's all he can offer. And I'd put in a complaint to the practice manager. I have every sympathy with over-worked GPs - but this is his job.