Diabetes + Steroids = A Huge Challenge

In my last post about prednisone and its side effects, I mentioned how it wreaks havoc on my blood sugar. Controlling my glucose levels is critical, not just for the obvious reason that diabetes is very damaging to the body but also because I'm still battling metabolic syndrome.

I've discovered a great tool to help me track what I eat and blood sugar levels/insulin use: www.livestrong.com. The nutritionist at my endocrinologist's office gave me daily goals for calories, fat, carbs, fiber and protein, and when I record my food consumption on "My Plate" on the site, it provides a detailed breakdown of these components and more. Using the basic "My Plate" tool is free and for an affordable annual fee, you can get even more services. The website offers much more information related to health, diet, exercise, you name it.

One of the biggest eye-openers for me in this process has been discovering the benefit of fiber in my diet. Before I began taking steroids, I had noticed a significant correlation between fiber consumption and blood sugar levels. Fiber helps control blood sugar levels and much more: An aritcle in the August 2010 National Institutes of Health newsletter offers detailed information about the advantages of eating more fiber.

Photo by Rob Owen-Wahl

Prednisone: The Good, the Bad and the Ugly

It's been about four weeks since my liver rejection episode and it appears that things are steadily improving. My lab results are trending in the right direction (numbers are falling) and while bilirubin, ALT, AST, GGT, alkaline and the rest are still notably out of range, they are vastly improved from a month ago.

So the waiting game continues, with plenty of medication juggling to compensate for the liver issues and to accommodate changes caused by prednisone, the steroid I'm taking. I can't recall taking steroids in the past, so it's been quite an eye-opener.

Unfortunately, prednisone isn't going to give me a ripped physique. Yet I'm not gaining weight, either, which commonly happens, so I don't mind foregoing the muscles. Here's how prednisone has affected me so far, along with some of its other potential side effects:

Blood sugar - Mine is OUT OF CONTROL. Whether I eat a pint of Ben and Jerry's ice cream or a handful of plain lettuce, my blood sugar can jump to 300+ (or more). I take long-lasting insulin twice a day and short-acting insulin three or four times. I watch what I eat, as before, but need the extra insulin to keep my blood sugar in check.

Blood pressure - Had to increase my blood pressure medication.

Energy - This is a good news/bad news side effect. Steroids give you energy (no wonder athletes like them! however, they take a different type of steroid) and most days I can get more done than I have since my transplant. The flip side of this coin is that I have even more trouble sleeping. The result is that I have several really good days and then I'm wiped out.

Acne - The ridiculous back, shoulder, arm acne. Thankfully, don't have this and pray it doesn't pop up. As I told my transplant coordinator, this side effect could be a deal breaker.

Fluid retention - My ankles and feet have been retaining fluid off and on for a couple of weeks now. My doctor prescribed diuretics, but has pulled me off them due to other issues. Thankfully, the swelling is intermittent and seems to abate without the meds within a day or two.

Mood swings - I've experienced this, too, but thankfully not often. The moods seem to manifest mostly when I'm talking to a customer service rep at my insurance company or online retailer or something of that nature.

There's an informative web page on the Mayo Clinic site that offers a good overview of corticosteroids, including prednisone. It's been a good starting resource for me.

Photo by Patryk Choiński