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New to PMR--Diabetic

Posted , 14 users are following.

rich38490
rich38490

Hi folks. Just started this journey. I was an avid workout guy about 2 months ago and thought my pain symptoms meant I had "overused" muscles. So I dialed my workout way back...pain still. I finally ended up with a diagnosis of PMR. So my first visit with the RA folks, ended up with 800 mg of ibuprofen three times a day. She said she was reluctant to prescribe prednisone in that I am a Type 1 diabetic. It seems to me my sugars have been extremely high due to the stress of the pain. Any comments. Thanks. Rich in South Texas.

1 like, 24 replies

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  • rich38490
    rich38490

    Posted

    Also, I find that sitting at my desktop for long periods leads to stiffness--duh :-). Has anyone tried one of those sit/standing work stations? 
    • JanetGarrett
      JanetGarrett rich38490

      Posted

      Sorry, I failed to mention in my previous reply have you tried replacing your office chair with an exercise ball just for starters to see if it helps?

      Janet

  • Anhaga
    Anhaga rich38490

    Posted

    Ibuprofen won't work for PMR.  If you find it's getting rid of most or all of your pain then the diagnosis needs to be rethought.  Ibuprofen comes with its own set of side effects, including the fact that it, like most nsaids, is hard on the stomach.  It also has been implicated in causing increased risk of heart attack and stroke.  

    • rich38490
      rich38490 Anhaga

      Posted

      Agree as I am learning more about this, thank you. Rich
  • ptolemy
    ptolemy rich38490

    Posted

    I really don’t understand doctors. It is very clearly documented that steroids are the only thing that really sorts out PMR and that NSAIDs are really a waste of time. Why don’t they check these things instead of giving people the wrong medicines which is just a total waste of everyone’s time and also not very pleasant for the patient.
    • rich38490
      rich38490 ptolemy

      Posted

      Thanks, I go back in 10 days, if I don't get a change in script, I am going to get a new doctor. 

    • dmart7
      dmart7 ptolemy

      Posted

      NSAIDs are not normally recommended for PMR because they are less effective than steroids and have too many side effects and risks.  These risks mount significantly when NSAIDs are taken in high doses for long periods, as would normally be needed for PMR.  However, there could be circumstances where Pred is unsatisfactory and a doctor would try an NSAID, presumably with a  protective PPI, to see if it provides a degree of relief.  I suspect that this would invariably fail but would not second guess a doctor who tries it.  NSAIDs (along with paracetamol) are even listed by NHS as something "your doctor may recommend"..."to help relieve your pain and stiffness while your dose of prednisolone is reduced".  

  • JanetGarrett
    JanetGarrett rich38490

    Posted

    Welcome Rich, s

    Sorry you are here also. You did not mention your age but you sound on the younger side as I am. Average age onset for PMR as73 I was just after my 55th birthday last year. So I've been here about 8 months on starting 15 mg prednisone with some attempted triggers in between thyroid situation complicates so I'm currently down to 13 mg but unable to taper at present. I have seeing an increase in my cholesterol HDL lowering of my LDL and increase in My fasting sugars. I am not diabetic but prednisone can certainly push us there. However I have spent many months researching diet and have learned that the ketogenic diet can reverse these inflammatory markers yes. You might give it a look see if it would be helpful for you particularly adding prednisone since it is an average of 5.9 years to remission. I spoke with one person here recently. Had reversed her markers I've addressed by 50% and about 6 months using the diet. Worth researching. As an added bonus I have lost 14 lb. Good luck to you I know how frustrating this is.

    Janet

    • rich38490
      rich38490 JanetGarrett

      Posted

      Thank you. Ketogenic diet makes sense for me. Just not sure about energy levels, etc. I am thinking maybe a gradual approach to reducing carbs. Appreciate sharing your experience. 

      Rich

    • EileenH
      EileenH rich38490

      Posted

      It takes a week or so to get used to ketogenic - but low carb is as good for most people and you have fewer problems getting used to it. My energy levels are no lower on low carb than a more "normal" amount of carbs. In fact, I do feel better on low carb.

  • Anhaga
    Anhaga rich38490

    Posted

    Can't help, really, with the diabetes type 1.  But have you seen a diabetes specialist?  They must have some knowledge of this and will know better how the blood sugar can be controlled because I think if your diagnosis is accurate you really will have to take pred.  Whatever is done normally to maintain your blood sugar at a healthy level will no doubt have to be adjusted, and a specialist is the person to manage that, in conjunction with yourself, of course and the way your PMR responds to pred. 

    Good Luck!

    • rich38490
      rich38490 Anhaga

      Posted

      Thank you. The RA indicated they will work with my endocrinologist to try to develop a plan to monitor glucose and treat the PMR pain symptoms. I will go back to the RA on 7/9. Stay tuned, thanks for the well wishes.
  • mary19068
    mary19068 rich38490

    Posted

    Hi rich38490

    When i was diagnosed with PMR i did nit see my usual doctor and the doctor i saw prescribed preds 25mg. When i saw my usual di tor approx 3 weeks later she was outraged that the other doctor put me on preds because i have type 2 diabetes. Preds raise your blood glucose levels also blood pressure, both of which have to be kept at normal levels with diabetes 1 or 2. Also, i had tegulare checks on my kidneys. Needless to say my blood glucose was high also my bp, therefore having to raise metformin dosage and blood pressure meds while lowering preds. It was all a viscious circle! Long story short i'm off preds now and glucose levels and bp are normal kidneys are fine.

    Would like to mention overdoing exercise can put a strain on your adrenals and in turn they will release high levels of cortisol that can make you feel unwell and give you gastro problems. Also, you do not mention how old you are...

    • rich38490
      rich38490 mary19068

      Posted

      Thanks, Mary, it sounds like you eventually got to remission. Were you on preds to treat the pain--and managing bp and glucose--before you got to remission? Age is 75. Agree with the exercise--I still work out, but its more "activity and motion" rather than "strength and endurance" :-).

    • nick67069
      nick67069 rich38490

      Posted

      Endurance exercise would be good for you from many prospective. It increases blood flow ( good for PMR) and also decreases blood sugar. Strength exercise would lead into muscle wasting with PMR/Pred combination, so be careful. Metabolic processes would change with pred.. it blocks protein reconstruction, so muscle never recover after breakdown during strength exercise. Pred also creates spikes in blood sugar, but it can be minimized by proper timing between food consumption and taking medication - this may be individual and the only way to find what works for you is thru experiments.
    • Anhaga
      Anhaga mary19068

      Posted

      Cortisol will not be released by adrenal glands after being on pred for several weeks. 
    • rich38490
      rich38490 nick67069

      Posted

      Got it, thanks. My "endurance" workout is pretty skinny right now compared to where I was. I do 30 minutes at 2.7 mph. Thanks for the input. Do you have a regimen to suggest?

    • mary19068
      mary19068 rich38490

      Posted

      Hi rich38490

      Preds were to alleviate the pain but they interfered with my blood glucose which was raised along with blood pressure when on pred. I tapered off pred over a year because i was tired of blood glucose and bp going up and down and various other side effects of pred. My diabetic doctor wanted me off pred due to adverse effects on my type 2 diabetes. All in all the preds made me feel dreadful. However, i am doing fine now, i do get pain intermittently which i put up with rather than go back on pred. Mild exercise helps. As Anhaga stated the adrenals wont produce cortisol if you have been on pred for a number of weeks, but you stated in your post you had just started your pred journey....You will get lots of help and advice on the forum....hope all well in South Texas...

    • nick67069
      nick67069 rich38490

      Posted

      the best is to stick with same type of endurance exercise that you did before PMR and start at very low intensity at first. Over time, looong time, you should be able to get back to the same level, but it took me almost a year of gradual, careful increase in distance and intensity to get back where I was before.
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