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The impact of Prednisone on A1C
Polymyalgia Rheumatica (PMR) | Last Active: Apr 25, 2023 | Replies (15)Comment receiving replies
One of the first things my endocrinologist checked was my insulin level. He suspected my insulin level would be high even though I had never been diagnosed with diabetes or prediabetes.
https://physicians.dukehealth.org/articles/even-low-doses-prednisone-creates-insulin-resistance
My endocrinologist was correct because my insulin level was high but my HbA1c and glucose levels were always borderline normal while I was taking prednisone. Nobody had ever checked my insulin level before.
My endocrinologist started me on Metformin because it is suppose to help prevent insulin resistance. He added that I should have been on Metformin during the entire time that I was taking prednisone for PMR. He said a high insulin level was a precursor to diabetes.
https://www.cdc.gov/diabetes/basics/insulin-resistance.html
My endocrinologist said that Metformin will only help with insulin resistance. My endocrinologist thinks that staying off prednisone along with diet and exercise will help more. Now I have to explain to other doctors why I take Metformin when I haven't been diagnosed with diabetes. I think Metformin is helping because now my HbA1C and glucose levels are well within the normal range and aren't borderline anymore. I will ask my endocrinologist to recheck my insulin level when I see him again.
Replies to "One of the first things my endocrinologist checked was my insulin level. He suspected my insulin..."
dadcue,
I agree with what you're saying. At the beginning of my PMR all my HbA1C and glucose levels were fine. About 6 months later I had a complete lab screen and suddenly I was "pre-diabetic" which was a shock until the rheumy explained that it was very common for those on prednisone. I've been on Metformin since and my levels have dropped back down. I'm still taking it although my pred dose is only 2 mg now and that's fine with me.
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Thank you - I am sure my issue is related to prednisone - no one on either side of my family has ever had diabetes, for starters. The weight gain has not helped either. My rheumatologist has not suggested anything about this and when I asked her to to test my blood sugar levels, she said that was up to my GP. I do not understand this division of labour, but were I to start complaining about gaps/problems with medical treat, well, I would probably never stop. When my Blood test results come through, I will decide about Metformin.