PMR and peripheral neuropathy

Posted by gfalck1952 @gfalck1952, 3 days ago

I seem to have developed peripheral neuropathy since getting PMR. Anybody else have this experience? I read something about nerve 'plaque' being the cause of the neuropathy. Is there any truth to that and is there a cure?

Interested in more discussions like this? Go to the Polymyalgia Rheumatica (PMR) Support Group.

John, Volunteer Mentor | @johnbishop | 3 days ago

Hello @gfalck1952, I thought you might want to join in on another discussion on the same topic here:
-- Peripheral Neuropathy and PMR?: https://connect.mayoclinic.org/discussion/peripheral-neopathy/

Mike | @dadcue | 3 days ago

Peripheral neuropathy was one of my problems after PMR was diagnosed and after Prednisone was started. Which one might have caused it is hard to know. The neurologist said it was idiopathic since I wasn't diabetic. However, you don't have to be diabetic to have elevated blood sugar levels. Even borderline diabetes can cause peripheral neuropathy.

When I saw an endocrinologist after being on Prednisone for 12 years some light was shed on why I might have peripheral neuropathy. Prednisone causes blood sugar spikes so without a doubt I had elevated blood sugar levels some of the time. Corticosteroids also interfere with how the body uses insulin which can cause hyperglycemia. The endocrinologist said I should have been treated with metformin the entire time I was on Prednisone simply because it reduces the risk of insulin resistance and diabetes.
https://pubmed.ncbi.nlm.nih.gov/35525318/
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My peripheral neuropathy was likely due to how Prednisone interferes with glucose metabolism. My endocrinologist checked my insulin level and it was very high. He said if I had stayed on Prednisone, it was only a matter of time before I would have developed diabetes. He said insulin resistance is the precursor to diabetes as a manifestation of Prednisone induced metabolic syndrome.
https://www.nature.com/articles/s41574-022-00683-6
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And ... for more details
https://www.ncbi.nlm.nih.gov/books/NBK507839/
" The predominant consequence of insulin resistance is type 2 diabetes(T2D). Insulin resistance is thought to precede the development of T2D by 10 to 15 years."

Nobody ever checked my insulin level the entire time I was taking Prednisone. My blood glucose level was checked often and it never reached the threshold of diabetes. My primary care doctor only said I needed to reduce the amount of Prednisone I was taking so I wouldn't become diabetic. He considered metformin but never prescribed it.

I'm off Prednisone now. My peripheral neuropathy seems to be improving instead of getting progressively worse.