Diabetic

Hello jilly, I'm sorry to hear of this recent bother and I'm afraid there is nothing I can tell you that would be of help.

my husband is type 2 diabetes and I remember his nurse saying 

Do you have GCA, PMR or both?

 

Oh crikey what happened there! But let me continue, his nurse says that whilst his readings are under 10 she's very happy with him, so I guess you must be on the absolute borderline. 

Preds can bring on steriod induced diabetes, and I understood that as the preds decrease they reexamine your diabetes as that more often than not clears up too.

i was referred to a rheumatologist only because I was classed as atypical, meaning something about my PMR is not as standard. In my case I was 52 when symptoms first appeared and that is classed as young, therefore outside the"standard" expected age group, therefore, referral. If your PMR is posing you no problems and you are reacting to the preds well then your GP may not think it necessary to refer you. However, one would hope that he will at the very least take bloods occasionally, just prior to a reduction just to see if all us ok. But if you are not reporting any flares, then he/she may not bother. But for me I'd be happier if they were to take them maybe twice yearly. Hope that's of help, regards, Christina 

 

Hi I have had PMR for 2+ years.  My blood test for diabetes was borderline last year but I was retested a few weeks ago and all levels are now fine.  It seems that taking pred increases your markers fro this but when you decrease the dose the reading go down.  I have had a few problems with chest following getting the flu at Christmas and had a persistant cough some months later which wouldn't clear even after two lots of anti biotics a chest x-ray recently came back as clear so just trying to be patient (again).  I have changed doctors and have just been offered a referal to rheumatologist.  I agree more frequent blood tests should be offered.  All the best, 

 

Hi Jilly, Just read your message.  I can identify with you.  I have had one appt. with Rheumy and that was due to a cancellation.  I was in and out in less than 10mins, no bloods carried out.  (I was already diagnosed by a locum dr. from my practice that I have PMR) that was November last.  I haven't had blood work done this long long time.  I have reduced from 20mg down to 10mg and I am winging it.  So I can empathise with you. Good luck.  Regards Pat

Jilly, yes, unfortunately, steroids can induce diabetes in susceptible people, and you will need to concentrate on reducing the carbs in your diet.  

If you had raised ESR and CRP markers of inflammation, your Dr should be repeating those tests very frequently in the early days, especially before any planned reduction in dose, just to confirm, along with your symptoms, that each current dose is maintaining control of the inflammation before the next reduction.

Ask for repeat blood tests and, at the same time, ask if you can have referral to a dietitian for advice  on nutrition for diabetics.  If you don't have any joy, then ask to see a different GP or for referral to a rheumy.  Some patients are confident that their GPs have the knowledge to manage their PMR, whereas others find it helpful under a good reheumatologist.  A leading expert on PMR in the UK says that he would prefer everyone to have at least one appointment with a rheumy.