I told my Internal Med doc that I had taken some prednisone prescribed by an ENT for a sinus infection. I even commented that I didn't want to take it at first, because I knew it would raise my blood sugar, but by the second week, I caved. Was he listening to this? He kept nodding his head and typing on his laptop. I thought he was taking notes. A couple of weeks later (after bloodwork), his nurse called me and said he wanted me to log my bg readings before breakfast and before dinner for two weeks. I asked why and she said something about lows??? I thought that was a strange thing to say. I usually am in the practice of logging my bg readings not only before every meal but two hours afterwards. Since had been taking prednisone, I was not doing that. I was to come into his office after two weeks. Guess what he said? My A1c was a high 7. ??? I replied that was quite high, but I had expected it to go up since I was on prednisone. He actually asked me if I thought that was the reason. I just said, "yes." I didn't tell him he had wasted several hours out of my life that I couldn't afford to waste (I'm 77), and my health insurance premiums were already over $200/mo. I thought everyone in the medical field knew that prednisone would raise the blood sugar in a diabetic. It bothers me to think he didn't know that and didn't listen when I told him. I was embarrassed for him. And now I am a bit afraid of him.
Did you do anything differently w/ the prednisone? I had a very bad (like 1 month...) case of bronchitis a few years ago (2008 I think...) and recall cranking my basal rate up to 200% of the normal amount which seemed to manage the steroid (I don't recall, I think it may have been prednisone too...). I usually try to manage my BG tightly before A1C tests but perhaps I just always tightly manageit? I would probably not have stopped doing what you had been doing w/ the logging and maybe changed it a bit? It may also be that, in addition to the prednisone boost, you also had whatever they were rx'ing the prednisone for pushing things up.
I would also be disinclined to pay much attention to what an ENT would say about BG/ A1C, etc. That's for the endo/GP or whomever you see for that. I had a weird sports injury recently (sprained calf, w/ hematoma, ENORMOUS swelling and, to top it off, my ankle then foot and toes all turned black and blue...it's better now but diabetes+ black and blue toes= eeek to me!!) and *NONE* of the doctors inquired about my A1C/BG/etc. which I found a bit disturbing.
Everything I've read on the Internet says prednisone raises the blood sugar of diabetics. I use Novalog Mix, which is never supposed to be used on the sliding scale. My doc prescribes how much I take before breakfast and again before dinner based on logs I give him showing my test results before each meal and 2 hours after. I've taken prednisone three times and each time it has had an effect on my A1c. It's always above 7 after I take it.
I have taken prednisone for breathing problems/asthma, severe poison ivy and skin rashes. I will try never to take it again. I even think it may have played a role in my D, but obviously I have no proof of that. I also had an injection for my shoulder- for severe bursitis a few months before D, I could not lift my arm, within in one minute after the injection I could lift my arm, but I also did 3 months pt as I still had lots of pain. I think oral pred is much worse than injection. I definitely think when I was on oral pred it was affecting my bg. I felt very ill, dizzy, sweating etc. I wasn't testing then though and had no idea I had D. I think it's common knowledge that Pred can bring D on even if you're on it for extended times. For breathing it is really necessary at times but I would try to avoid it for other things now. I don't know what to say about your ent- I usually just listen to my own advice when I know they're wrong. I think it is pretty common knowledge pred will raise bg. I would not take if for a sinus infection again- just use steaming water, showers, decongestants etc. and natural anti inflammotories like arnica. I'm using that for inflammation in my knees along with etolodac for a few weeks- I dont' like taking the other anti-inflammatories either but a few weeks seems to get me through and help me recover< When I was thinking about an injection for my knees, my endo said just monitor bg and increase insulin if I go too high. br/> .
Hi Yvonne, I'm 82 y.o. and I hate to waste time as well. When I get poison ivy, as I did early this month, I have to take pred to keep my eyes from swelling shut, along with the fact that it spreads from head to toe. If I followed the instructions on the pkg. of pred, I'd go into immediate DKA! It calls for 6 pills the first day, etc., but I get good results from one pill with each of my three meals, tapering that down to two, then one, as quickly as possible. My doctor trusts me to get it right--I've been doing this treatment for years--but the pharmacy folks didn't have a clue about what a person my age with Diabetes should do. I hardly ever write anything here on TuD without noting that we're each so individual. Since I averaged approx. 250 BG while on the pred., I'm not looking forward to getting my next A1C result!
Had to take prednisone for two years for a serious nerve inflammation. The highest my A1C went was 6.7 after 3 months. I went very very low carb No Potato No Pasta No Rice No Bread. Sometimes I ate only 10 carbs a day. My next A1C was 6.4 and then the amount of prednisone was reduced gradually for the next year and each time I took less prednisone my A1C went down to 6.2 and at very small amount of predisone A1c was 6.00 by the time I no longer needed to take it. 4 months after I discontinued the prednisone my A1c was 5.5 which I attribute to the lo carb training I had been following. Oh and I also discontinued taking 5mg of glipizide when I discontinued the prednisone and only continued with the 10mg. of Lantus and with just the Lantus my A1C was 5.5 after 4 months off prednisone. Now I take 5mg o Levemir in the AM and 5mg in the AM. My last A1c was 4.9 and its usually 5.4 or 5.5.
That is amazing. Really. I've taken it three times and all three doctors advised me it would raise my blood sugar, which it did. My doctor didn't seem to know this, and that was what surprised me. I've heard that most doctors do not like to keep patients on prednisone for very long. I've heard one of the reasons from a retired RN, but haven't heard this from the horse's mouth, so won't pass that on, but what she told me was enough to cause me to take it seriously.
I had a friend who got poison ivy almost every summer and because she had lymphodema from removal of lymph nodes during a mastectomy, she had to take prednisone. I don't know how she managed to get poison ivy every summer :))) She was a dear lady. Lived into her 90s.
Yvonne
I think doctors sometimes are just misinformed. The prescribing information clearly says:
Corticosteroid therapy may induce glucose intolerance by reducing the utilization of glucose in tissues and increasing hepatic glucose output. Patients on alternate day therapy may exhibit significantly higher serum glucose on the day prednisone is taken. Diabetes mellitus requiring therapy with diet modifications and hypoglycemic agents has developed in some patients.
I've also encountered the "not my problem" situation where a doctor like an ENT will consider diabetes the endo's problem and they could care less about your blood sugar because that is someone elses job. I had similar problems with statins where I was eventually put in the hand of a cardiologist who didn't care about the damage the statin was doing only whether I died from cholesterol.
Sometimes, we need to me more forceful. It is ok to ask a doctor to show you the prescribing information and prove it is safe especially when you know it isn't. And we have a right to decline treatment, ultimately it is our decision.
Thank you for posting a link to the side effects of Prednisone. I had not read all of them for some time. It was a reminder to me how dangerous taking Prednisone can be.
Now I will repeat what my old friend (retired RN) told me about Prednisone. She said every time she saw a woman with a hump back, she knew they had been on Prednisone!!! It is not a drug to be taken lightly.
Thank you.
Oh. Yes. I understand the "not my problem." I saw that when my husband was alive and had a heart problem. When his bladder began emptying without warning, no one was able to tell him why. Heart docs would tell him, this is not due to a heart problem. Period. After he died, I ran across an article that said those shots he took for back pain (steroid) could cause the bladder to malfunction. hmm. He hadn't had one in a long time when his heart condition became worse that last year, but I will always wonder.
Yvonne
I took Prednisone for a week during to deal with chronic sinus infections. I ended up in hospital with a yeast infection, still existing sinus infection and BG of 27 (486). This was when I was diagnosed with D. I was put on insulin, and ended up taking smaller and smaller doses over time. Close to a year later I went to an endo seeking answers, he did a bunch of blood tests, and told me that I am not diabetic it was probably just the prednisone.
I will never take oral cortisone again, although I have used a nasal spray (prescribed by an ENT) which did help without the huge jump in BG.
I can't believe your doc didn't increase your insulin dosage in response to the prednisone!
That is some story. I didn't know Prednisone would do that to someone who did not have diabetes. My doctor is a geriatric doc. Although he is not used to treating diabetics, he should know that it can raise your blood sugar. I was stunned when he did seem to be aware of this. About six months ago, I stopped seeing my endo. He was very good with diabetes but insisted I start taking an additional blood pressure medicine. He wouldn't listen to me. It's a long story. The geriatric doctor had a wonderful physician's assistant whose father was diabetic, so he knew things a lot of doctors do not know. What I didn't know, was that he had left and had moved to the southwest. Not good. My blood sugar came back down pretty fast.
Well, they think I am predisposed to having D because of family history. A couple of years later and I have since been diagnosed with Type 2. I am still on the fence about going back to the endo and getting a clearer diagnosis again though, since I am in my 30's, with normal blood pressure, only 2 or 3 kilograms overweight and have very low cholesterol.
I must admit my experience of older doctors has not been very good. The first specialist who diagnosed me did no tests at all. I remember begging him to do the HBA1C. This time around I started with a regular doctor who took bloods and did the HBA1C straight away, without me even bringing it up. I think a lot has to do with when the doctors were trained, because so much new research has occurred since then.
For me, the effects of the prednisone lasted at least 6 months. I'm glad to hear your blood sugar came down faster!
I don't know why there is so much ignorance about type 2 diabetes, but there is. My endo and I laughed about the fact that so many internal medicine doctors think they know about diabetes, but they usually do not. I'm surprised you found one who had the sense to do an A1c. I think everyone over 40 should have one at least once a year. My oldest dau had a reading of over 200 one day when she visited her doctor and he didn't gt upset about that at all. My two youngest daus have been diagnosed with diabetes. It's on both sides of my family. All my siblings had it. It bothers me a lot.
Yvonne, I have had diabetes for almost 46 years. Medicine is a practice, Remember, so many doctors are "practicing" on you. I have found that many professionals in the medical field are not fully educated about diabetes at all, regardless of the type. My internist is kind hearted, but he is not the go-to person for my diabetes questions. I do not expect any of my other specialists to know a thing about my diabetes, so I do the research myself, ask my endo and my pharmacist.My endo knows a lot, but he is comfortable enough with the research I do on meds before he expects me to take them. He knows I will ask a lot of questions and present the evidence I get from my own research before I willy-nilly take prescriptions. I got a new prescription, from him for a statin recently, and am going to do more research and check out what I can do with homeopathic meds before I take it. My cholesterol would be considered optimum, BTW, were I not in the demographic his practice routinely gives statins to ( black, middle aged, diabetic). Remember, YOur diabetes may vary ( YDMV)
God Bless,
Brunetta
My geriatric doctor is a very nice man, too. He just doesn't know as much as he should, in my opinion. My endo was a good doctor, but we locked horns on this bp med. I had already had a very bad experience with a med in that same family and I didn't want to go there anymore. My bp is fine. I take a med for it and it is the only one that works and doesn't give me bad side effects. The first side effect listed on this new drug is back pain. I have so much back pain that I walk with a cane, now. It's very bad. I don't need anymore. But he would not listen to me. I developed diarrhea to the point where I was afraid to leave my condo, as well, and it stopped working. It took over a year for my doctor to find another one that worked.
I've made a study of diabetes, too, ever since I was diagnosed. I'm on the best list on the Internet. But. I may need to stay alert to what this doctor is not doing. Can't remember if he physically checked my thyroid the last time I was there. I had to beg to get a copy of my last blood tests. He never checks my feet and I've had neuropathy since I was diagnosed.