PMR and type 2 diabetes

No doubt you'll hear from others about alternatives, but your post resonates with me, so I wanted to chime in with a summary of my experience with PMR and blood glucose.

I have flirted with type 2 for a decade or more, with my A1C rising and falling in parallel with my weight (obesity a lifelong challenge). Like your husband, I'm on Mounjaro and was officially diagnosed with PMR this summer (3 months ago).

My A1C rose from 6.1 to 6.8 following my first month of prednisone, 15 mg. (Yikes.) FTR I was in successful weight-loss mode that month. I'm not/never have been on any diabetes meds other than Mounjaro. My fasting blood glucose was also spiking into the 170's and a couple of 190's, whereas it "normally" floated between 125 and 145.

I started a Mediterranean diet a week before my diagnosis, and have been happily on it ever since. Heavy on the fruit, nuts, and veg. I don't do scales (old-timer, here, don't need the added stress), but am quite happy with my weight loss over these three months.

About a month ago, when I was tweaking my supplements to protect my bones and muscles, I ran across a recommendation to take Chromium Picolinate to lower blood glucose while on prednisone (sorry, no reference close to hand). My docs didn't object, so I added the in.

My fasting blood glucose this week has been really good: in the 115 - 125 range, with a nice 109 this morning.

I have no idea if it's the Mounjaro 7.5, the ongoing weight loss, the plant proteins, or the chromium, but I'm of course delighted in the so-far-so-good sense. (I'm currently taking 11.25 mg prednisone, gingerly searching for my lowest effective dose.)

30 mg prednisone is a lot. I'm only guessing, but I wouldn't be surprised to find that such a dose over time would be harder to combat in terms of blood sugar. Until he can sort through the possible alternatives, maybe some of what I've suggested can help.

Thanks for this bit of encouragement. We were able to get him an appointment with rheumatologist in 3 weeks so am hoping this will help. Meanwhile I am
Looking into chromium picolinate. Thanks.

Kevzara is an alternative treatment if he is a candidate.
I was so happy to ditch prednisone!

@maryjanecowell I forgot to add that after I started the chromium pickles (not a typo; i!t's what I call it!) I read a couple of journal articles that said the pickles may not be that good for you. It helps absorption, but may have other less desirable effects. I may look to move on to another form or chromium myself, but for now, it's hard to switch when I seem to be in a good place.

Hi!
I was diagnosed with GCA/PMR in April after a 2 week stay in Mayo. I’m 67 & have had type 2 diabetes for over 30 years. I was on very high doses of steroids in hospital & when home, 60 mg. Of prednisone. You can imagine what that did to my blood sugar! I was put on high doses of insulin to try & deal with that. I’ve been on Trulicity for 5 years & now am on. Novolog & Lantus as well. But one of the most effective things I’ve done is change my diet. I do anti inflammatory; sugar free, gluten free & eat at regular intervals. It’s mostly Mediterranean with lots of lean protein & carbs from fruits & veggies & brown rice & sweet potato. Steel cut oatmeal most mornings with egg on the side for protein.
I’ve been tapering down from prednisone over the past 4 months with the help of biologic Actemra. My extremely high CRP of 266! & sed rate 78 have come down to normal. I still have some symptoms but not often & not severe. My prednisone is 8 mg. right now. If all goes well, I should be off prednisone by end of year. Actemra had been a lifesaver!
Also, need to add this: as I started feeling better recently, I added mild exercise. Especially helpful after my meals. Just a 10-15 minute walk for now.
I’ve been slowly cutting down how much insulin I have to take as prednisone is reduced.
Has your doctor started tapering your husband’s prednisone yet?

He is at a steady 30 mg right now (as per our GP instructions) until
His Rheumy appointment end of September. She was hoping to taper it from 40(three days) to 30 (for three days) to 20 to 10 to 5 For a total if 15 days. When he drastically got worse when he got to 20 we stopped that tapering regiment and went to a steady 30 for the next three weeks. Hopefully rheumy will get him
to some of the drugs you mentioned. His diet sounds very similar to what you advised. Thanks so much for the confirmation that he’s doing some of the right things and for taking the time to respond. We appreciate it!

@caroljeand hopefully our rheumy appointment will direct him in that alternative to prednisone direction. Thanks.