Hi everybody,
My hbac1 level fluctuates between well into normal range and sometimes, more often recently, into prediabetic range, wavering around borderline 42/43. My doctor says I’m borderline prediabetic because of being on long term steroids. I hope to be able to perhaps reduce these over periods during the year, but unfortunately I’m stuck on them. Is anybody else in this situation?
I’m wondering therefore if the BSD can impact or reduce the effect of the steroids? My bmi is 22 (having lost 2 stone over the last year – the recent hbac1 reading of 43 was after I’d lost weight unfortunately), so whilst not massive, I have got a bit of margin for some weight loss, and it is indeed my tummy that takes on weight. My waist could definitely afford to be slimmer at 31.5 inches dead on. My diet is relatively good, although wine & carbs did definitely creep back up over the autumn after getting into the habit of wine on holiday!, and for sure I didn’t restrict myself much over Christmas.
Anyhow, to avoid rambling on, I would like to see if I can reverse the current steroid trend into prediabetes, as am worried about the progression and would like to halt it. Am concerned about too much weight loss with the fast 800, (also migraines), so wonder whether the bsd 5:2, or simply the Mediterranean diet are sufficient to reverse things? As it seems there is much evidence of the effectiveness of the 2 month 800?
Any advice welcome. Not sure if there is much research into the diabetes caused by long term steroid use?

Sorry for double posting, I realise I should have posted in this introduction forum first, introducing myself (hello 😊). Hopefully mods can deal with my double posting misdemeanour 😊

Hi Molly
I don’t think I can help you but I wanted to acknowledge your cry for help. It sounds like an awful situation to be in and I hope you find the solution. My own personal thoughts are that if you don’t have much weight to lose then maybe the 800 BSD may not be the way to go but switching to the Mediterranean way of life may suit you better. You don’t count calories but eat low carb, which should help reduce your blood glucose.
43 is only just in the prediabetic category and your weight is in the healthy range so focussing on carb intake to reduce blood glucose maybe could be your focus. But reducing carbs your bg should go down and your weight will follow. I’m sure you’re well aware of the advice about increasing exercise to improve bg so I won’t repeat it here but worth bearing in mind.
These are just my thoughts… good luck.

Hi Molly D and welcome to the forum

I have heard about steroid-induced Type II diabetes but I don’t have any personal experience of it I’m afraid. If nobody else here is in a similar situation to you it might be worth having a look through the forum on the diabetes.co.uk website. I’m a regular visitor to the forum. It’s very similar to this forum in that people with different types of diabetes (and including prediabetes) get support, post questions etc. I know I have read of people having steroid-induced Type II diabetes so if you use the search box you may come across some info that is helpful. If you register (it’s free) you could also post a question and someone may be able to signpost you to research (or there may be info on the main site). I’m not working for them, honest! – just think it might be an additional source of info for you.

In terms of which diet to do to suit you I’d say you have choices.
Michael Mosley himself did the 5:2 diet and that worked for him (I think he was just into diabetic numbers and got back them back down into the normal range). Like you, he didn’t have that much weight to lose.
I did the 8 week Blood Sugar Diet (the pre-runner of the Fast 800) which worked for me (mind, I mixed it with low carb as I did 800 cal/20g carb). My blood glucose levels went back into the normal range quite quickly. I lost about 21lbs over 8 weeks but most of it was front-loaded. So, you could try that just for a few weeks to avoid losing too much weight. Because I monitored my bgls throughout I know they started to come down quite quickly – within the first 2 weeks – so it should still have an impact.

As Gattina says, the other way you might be able to do it is through the Med diet – maintaining your calorie intake so you don’t lose any more weight but keeping your carbs low – there’s a lot of evidence for this being effective too, and, in fact the American Diabetes Association have just recently formally advocated using a low-carb diet as one of the methods of treating Type II diabetes. I know you mention that you are doing low carb, but it might be that if you tighten up on that you could just do that.

One last idea is to maybe build in to whatever you do a little bit of time restricted eating (and/or fasting) or just don’t snack between meals – according to Jason Fung this helps with keeping your insulin levels lower which is what you’re also aiming at. Having said this, I’m ignorant about taking steroids and whether this means this is doable while you’re on them.

Not sure how much help the above is but thought I’d post it. I’ve rushed it as I’m about to make my (BSD-friendly) dinner so it might be a bit garbled. Anything that doesn’t make sense, just give me a shout and I’ll get back later.
Jennie xx

Thanks Jennie for such a long and detailed reply, and your warm welcome 😊. I’ll certainly check in with Diabetes UK as you suggest, and the occasional fasting and fasting between meals both seem good things to try. Mediterranean diet is pretty much what I do (except at Christmas when I turn into a chocolate monster), so I’ll tighten up on that too.

Thanks again!

Thanks Gattina – yes, I’m sure there’s plenty of visceral fat still in there that some stricter dietary attention could deal with and that must surely help a bit. I’m hoping things will stabilise and not necessarily worsen if I can at least do what’s in my control. Thanks 😊

Hi Molly – yep, me too with the chocolate (crisps are the other one for me). I’m alright if it’s not around but if it’s in the house for very long I do find myself eyeing it up or hovering next to it a bit too long – when no-one is looking, of course! Luckily, this year the small amount of chocolate my family got either remained unopened or then had too few chocolates left for me to get away with pinching some without getting caught!

So, I never know if I’m teaching grannie to suck eggs when I say these things (sorry if I am), but one other thing I wondered is if you keep a record of how many grams of carbs you have each day? Because your hba1c fluctuates between normal and prediabetic, knowing what your daily carb intake is should help you to get an idea of how many is too many i.e. leads to a prediabetes hba1c. If you get a prediabetes hba1c result on one level of carbs you could try lowering them bit by bit until your hba1c goes back into the normal range. Lots of people use this technique successfully. If you don’t do it already it might be worth a go. I use fatsecret.co.uk to track my macronutrients, including carbs.

Keep posting and join in any of the threads you want to.
Jennie xx

Thanks Jennie, you certainly aren’t teaching me to suck eggs 😊, the fat secret tip is really great, thank you. I also spoke to Diabetes UK, who didn’t really have much knowledge on the steroid induced side of things but said I was doing all the right things and that prediabetes wasn’t a ‘condition’ anyway. I’m certainly interested in logging my carbs so will install fatsecret app. I don’t quite know though how I could get the hbac1 tests with the frequency you suggest I try. My thyroid has gone a bit out of whack so I’ve got to get to get a blood test for that after a couple of months medication increase, so I suggested to the doctor that maybe I get the hbac1 test at the same time to see if I’ve improved matters. He said there was no point as I seem to fluctuate too much, so just to get the usual annual blood test later in the year… so I’m not sure how I could begin to calibrate tolerable level of carbs for myself without blood testing.

And yes…. crisps – my nemesis! We try not to have them in the house, although with teenage daughters around, I can’t deny them occasional pleasures. I switched to roasted peanuts instead, though they’re a might calorific.

Thanks for your tips. X

Hi Molly
I have the same problem with blood testing – the healthcare professionals are reluctant to run the hba1c test too often. It is a reading over 3 months so it takes a bit of time to show a difference. But the daily blood testing helps me keep an eye on things – the nhs no longer prescribes blood testing kit to people with Type 2 diabetes unless there is a very specific reason. I have my father’s old monitor and buy the testing strips online – it is expensive but helps me to keep on track of my bg.
But sounds like you’re doing lots of positive changes in the right direction.
Best of luck

Hi Molly,
Yes, because you mentioned hba1cs I thought you might get them every 3 months. That’s a shame. I guess you could calculate how many carbs you’re taking at the moment and then lower them by some and see what affect that has when you do get your annual blood test taken.
Like Gattina, I also self-tested my bgls and found it really helpful. What it did show was what happened. As soon as I started the BSD, my bgls started reducing really quickly (within 2 weeks) and got back down into the normal range long before I got into a healthy BMI, or even close. I’ve read experts say this is quite typical. For me, losing weight was important (I had a lot to lose) but I really think it’s the carbs that are the key.
The other thing I find is if my bgls go up (usually when ill) I’ll fast for up to 20-24 hrs and that brings my bgls down e.g. 6 to 5.
Again, not sure how much this helps but if I do come across anything on people’s experience with steroid-induced diabetes I’ll post it.
Jennie xx

Hi Jennie
that’s good to hear about your bg readings. Mine was very high before Christmas and I’ve started taking medication but I don’t like the side effects. I hope to get my bg back to normal again so that I can stop taking the medication. The fasting tip is really useful.

Hi Gattina
Yes, I read about the results of your annual diabetes check on another thread – sorry to hear about that. xx

My story is similar to yours in that I got my bgls back into the normal range, lost 6 stones, kept it off for about 20 months, then put 2 stone back on. I kept to low carb (so my daily bgls went up but stayed within the normal range) but just stopped checking my portion size etc – you know how it goes. Anyway, I came back on here last year and have now just got back to 9st – and my bgls are now back where they were. You’ll get back there too, my friend, – and then neither you nor I will fall off things again.

See you on the January monthly thread.
Jennie xx