Steriod-Induced Diabetic (Newbie Here)

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Mormor Vicky
Veteran Member


Date Joined Mar 2007
Total Posts : 684
   Posted 6/22/2007 1:20 PM (GMT -7)   
Hi everyone!!!  I just have a few questions.  I found out I have Crohn's disease back last August.  I was put on Prednisone and quickly got diabetes.  I probably was pre-diabetic before.  Anyway as soon as I found out I completely changed my eating habits and exercise regiment.  No more fast food, eating healthy, watching carbs, no sugar.  Walking at least 30 minutes a day and going to the Y 3-4 times a week.  I'm up to several hours of cardio every other day.  I feel great.  My bg numbers are terrific.  Hardly ever over 150 after eating.  Mostly between 80-140 no matter when I check.  I've gone from taking Lantus & Novolog, to just lantus, to just 2 metformin (1000mg?) and now down to 1 metformin.  Metformin at 2 was causing stomach problems. 
 
Now that you have some background here are my questions?
 
Is it possible I no longer have diabetes?  maybe something like gestational diabetes.  Only be there while on steroids?  My ha1c have been 5.7, 5.6, 5.9 since January.  When I was in the hospital last Dec my bg was consistantly between 200-300 but I was on IV steriods at the time. 
 
I've been told to limit my meat to 3 oz but because of my crohn's I sometimes have a hard time eating fresh fruits and vegetables and I limit my carbs to 30-45 a meal.  I'm having a hard time eating enough to get full.  Right now I'm barely eating 1200 a day.  Is it okay to eat more meat/protein to make up for not eating fruits and veggies?  Will that hurt my diabetes?
 
Last question.  Why can't I lose weight?  Like I said I eat probably between 1200-1400 calories a day, exercise (mainly brisk walking) at least 40 minutes a day and on days I go to the YMCA I can work out up to 2½ hours a day.  I've gone months with only losing a pound or two.  I have an appointment with my doctor next month to go over all this but I'm getting frustrated.  Is there anything in the diabetic make-up that causes us to hold on to our weight? 
Vicky
DX'd with Crohn's August 2006 during a resection
DX'd with Steriod induced Diabetes November 2006
 
Currently only on 4000mg of Pentasa
6-MP caused Bone-Marrow Suppression


gelchick
Regular Member


Date Joined Aug 2006
Total Posts : 477
   Posted 6/22/2007 2:27 PM (GMT -7)   
mormor
 
I don't know what protein does to a person with Crohn's, but eating more protein is unlikely to raise your blood sugar levels. In fact, folks who follow Dr. Bernstein's low carb eating plan are advised to raise the amount of protein they eat (as opposed to carbs) in order to fill up.
 
Your calorie restriction might be too much for your body. If you undereat, your body goes into starvation mode and tries to save every morsel that you eat as fat to protect you from the famine. I have seen studies that show routine undereating causes the metabolism to slow down too. The result is that you become fatter, you require fewer calories to fuel your body and you don't lose weight. The best way to lose weight is to build more muscle and eat enough to sustain a loss but not so little that you go into starvation mode. Building muscle also decreases your insulin resistance- which leads to better BG numbers and allows you to eat more because it takes energy to maintain muscle. It's a win-win situation for your body image and your diabetes :-) sandy
I just want to live happily ever after-every now and then. Jimmy Buffett


Jeannie143
Veteran Member


Date Joined Apr 2004
Total Posts : 6056
   Posted 6/22/2007 8:35 PM (GMT -7)   
Welcome Mormor,

My daughter has Crohns and I know how you have lots to juggle when it comes to the food plan.

Answers to your questions:
1. You still have diabetes and will always have diabetes. What you have now is controlled diabetes. But you are far luckier than the millions of peeps walking around with diabetes that don't know it right now. You are aware and treating.

2. You can up your protein a bit if you want to without hurting your sugars. Find some proteins that are easy on you. If you can't eat whole eggs just try the whites. If you can't do milk (which is really a carb!) try soy milk. Cheeses and cottage cheese are good too because the protein is combined with fat which enhances the absorption of fat soluable vitamins and slows stomach emptying time a bit. Long time diabetics with kidney damage often have problems with too much protein. This is why we are taught from day one to cut back on the meats. If you like fish such as tuna and salmon they are actually good for both your CD and your diabetes as well as your heart and brain.

3. Crohns presents its own set of problems with malabsorption in the small intestine so if you can't eat too much fruit or veggies you could try juicing and putting the juice in water (fruit) or soup (veggies) to get the nutrients. The problem with juicing is that it often dumps it's glycemic load all at one time. That's why I recommend diluting it with water or soup. V-8 vegetable juice-type cocktails (not the fruity fusion ones!) can also have carrot, kale, celery, beet and other veggies juiced into them for more nutrition without all of the fiber that makes you hurt.

4. Weight loss while on steroids is very difficult. You could put your weight loss plans on hold until you are weaned off the pred. I don't know your age nor all of your history but I do know that the pred presents its own set of problems including the diabetes and osteoporosis so be sure that you become educated about all of the aspects of your meds. My daughter chose not to start steroids after her fistula surgery and has quit all of her meds. She still has CD but she also is 4 1/2 months pregnant with her first baby and seems to be in remission. Her doctor is doing a study on pregancy and CD remission because of her :-).

One question from me... Was your nutrition educator just a diabetes nutritionist or was he/she aware of your limitations that your CD puts on your food plan? I can't really see a registered dietician telling a CD person that they have to limit their protein and then not give them an alternative to all the carbs when they can't eat as many veggies... A person's gotta eat! Having CD and diabetes puts you in the position of juggling your gut's needs vs. your blood glucose.

Keeping a journal and finding the right food combos for your situation might be the best way of staying in line. I know that sometimes my daughter used to eat only cottage cheese and pineapple for days on end when nothing else would stay with her. Baby food was a staple at our house when she was growing up, too. Do what works best for you and just keep checking those sugars. You will become your own best teacher. We have lots of crohnies that pop into this forum from time to time and I'm sure they will have lots of good ideas for you as well. Take care and read back in the posts for more ideas to keep your glucose in control.
~ Jeannie, Forum Moderator/Diabetes & Fibromyalgia
~Please remember that 50% of all doctors graduated in the bottom half of their class! Yours may be one of them...
==================
"People are like stained glass windows: They sparkle and shine when the sun's out, but when the darkness sets in, their true beauty is revealed only if there is light within."
- Elizabeth Kubler-Ross


Mormor Vicky
Veteran Member


Date Joined Mar 2007
Total Posts : 684
   Posted 6/22/2007 9:17 PM (GMT -7)   
Oh thank you so much Jeanne for such a detailed post. I haven't been on Pred since December and I think that is why my BG is so good. That is why I was wondering if I was still considered diabetic. I've heard of people having elevated bg while on Pred but wasn't considered diabetic. My GI said that if I have another flare then I'll have to go back on steriods. I'm not thrilled with that. I've had excellent control but I haven't strayed too much either.

So far I can tolerate almost everything to eat except really hard to digest veggies like corn. Having half my colon removed and all the diseased part can really make a difference in what I can tolerate eating. I just don't want to eat anything that might cause problems. I haven't seen a nutritionist yet because I've been able to control my bg on my own and since my crohn's is in remission I have been hesitant about having someone dictate to me what I need to be doing. I want to see if I can do it on my own first.

Finding out you have a chronic illness can take a while to get your head around and then finding out you have another one within 3 months caused by medicine was kind of hard for me. I feel like I've been put through the wringer. Finally getting to the point where I'm trying to experiment more with diet. I've been really good but now I want to expand and not limit myself too much.

My daugher also has crohn's and is 8 months pregnant with her third child. She was dx'd with Crohns when she was 12. She is doing very well. I never thought I had crohn's because I've always had weight issues and everything I can remember reading about it said that when you have crohn's than you'll lose weight. Hahahahaha. I had to be different.
Vicky
DX'd with Crohn's August 2006 during a resection
DX'd with Steriod induced Diabetes November 2006
 
Currently only on 4000mg of Pentasa
6-MP caused Bone-Marrow Suppression


Mormor Vicky
Veteran Member


Date Joined Mar 2007
Total Posts : 684
   Posted 6/22/2007 9:25 PM (GMT -7)   
Jeannie, I forgot to mention that Michelle also is off her meds and has been since she graduated from high school. Always said that the meds made her feel worse then the disaese did. I really worry about her especially with what I went through last year. I know that some day she will hit that brick wall and I hope that it won't be too bad. She hasn't even seen a doctor for her crohn's in almost eight years. I just know it's going to catch up with her.
Vicky
DX'd with Crohn's August 2006 during a resection
DX'd with Steriod induced Diabetes November 2006
 
Currently only on 4000mg of Pentasa
6-MP caused Bone-Marrow Suppression


4sons
Regular Member


Date Joined Dec 2006
Total Posts : 406
   Posted 6/23/2007 6:13 AM (GMT -7)   
Hi Mormor ... I have a son with Crohns as well. Yes, sometimes what's right for one disease hurts the other! No doubt about it. Sandy and Jeannie have given you EXCELLENT advice! Your A1Cs are just beautiful but I'm not sure they fall in the "normal" cetegory, I still think they're slightly elevated (ALTHOUGH I'D LOVE THEM, PERSONALLY!).

Congratulations on being able to cut back on your diabetes meds so successfully, that certainly is an indicator that you're doing the right things! I agree with Sandy that you still may be eating too much for your size. The book gelchick mentioned recommends the following carbs per meal: 6 at breakfast, 12 at lunch, and 6 more at supper. The carbs come from a select list of "allowed" veggies and YES, there are a couple of crackers that are also allowable (love Wasa Rye!!!). I think it was said that about 2/3 cup cooked veggies or 1 c. salad veggies is the equivalent of 6 grams of carbs. As Sandy said, if one is still hungry one needs to eat more protein.

I'm really going to give this a go for the next two months and see what it does to my A1C! I'm pretty goal oriented so this gives me something to shoot for!

Good luck and welcome!
Cheers -

Ruth/4sons

age 52/Type 2 diabetic/"controlled" by diet and exercise


Chutz
Veteran Member


Date Joined Jan 2005
Total Posts : 9090
   Posted 6/23/2007 11:30 PM (GMT -7)   
Hi Vicky,

I've had to be on pred a number of times...some short and others months long when I had a UC flare and a bad Dermatitis Herpetiformis attack. If I go much over a week I have serious problems with blood sugars. A couple of examples...about 2 weeks ago I was on pred for pneumonia for 5 days. On day 2 the bg's started to raise so I had to up the humalog. (I use lantus also) By day 5 I was doubling the humalog and struggling to get the bg's down.

When I was on it for several months I was tripling my insulin intake and still had numbers in the 200-300's some times. Not pretty! So if you were borderline or prediabetic, taking pred may have just pushed you over the line. Not a doc's diagnosis, just my opinion and thoughts...

Good luck,
Chutzie
Co-Mod Fibromyalgia & Chronic Pain Forums
~~~
Fibromyalgia, Ulcerative Colitis, Insulin dependent diabetic, collapsed disk, dermatitis herpetiformus, osteo arthritis in spine and other locations.
***************

The only difference between genius and stupidity is that genius has it's limits. Albert Einstein: (1879-1955)


itsme
Regular Member


Date Joined Mar 2007
Total Posts : 44
   Posted 6/24/2007 11:22 AM (GMT -7)   

Hi-- I also am diabetic from Steroids.  Got Autoimmune Hepatitis and was on massive dose of pred.  Blood sugars were in 450-350 range as a result.  The Doctor's are great, they fix one thing and screw up another.... Oh, well, at least my liver is returning to normal now....

I am on Levimir, adjusting my dose as the pred gets decreased.  I was told my the Endo. that I was probalbly predisposed, and the pred. pushed me over.  Oh, well, at least I am learning how to eat properly now, and even exercise once in a while.  This sounds weird, but the diabetis was probably a blessing in disguise.  I am paying attention to my health now. yeah

 


Mormor Vicky
Veteran Member


Date Joined Mar 2007
Total Posts : 684
   Posted 6/25/2007 5:04 AM (GMT -7)   
Hi Chutz and itsme, I've already decided that I hate the diabetes worse then I hate Crohn's. Even though diabetes has forced me to get healthier and I've been doing all the things I'm suppose to now it's always there. A part of my life. Reading labels, adjusting menus. Making sure I eat at a certain time, test my blood, get my exercise in, take my pills. I have no spondinaity (sp?) in my life anymore. At least I'm in remission right now with my Crohn's. As long as I take my meds I'm okay until the next flare. With diabetes, it is always there, lurking, making me feel quilty when I have eat something I shouldn't or depressed when I don't indulge. I hate it, I hate it, I hate it, I hate it.... You probably couldn't tell that I'm kind of depressed about it right now. Sometimes I just want to forget the whole thing. Pretend my body isn't falling about around me and just go back to a normal life like I had this time last year.

Sorry, I don't mean to be a downer. I just get overwhelmed sometimes. I'm tired of fighting the battles alone. No one in my family seems to understand or really even care.
Vicky
DX'd with Crohn's August 2006 during a resection
DX'd with Steriod induced Diabetes November 2006
 
Currently only on 4000mg of Pentasa
6-MP caused Bone-Marrow Suppression

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