I supposedly have metabolic syndrome which is a way of saying that I am developing diabetes and have liver involvemnt. The normal range is 80-120, though you can check the pamphlet that came with your meter to be sure. It will take a long time for your sugar to stabilize if you are or just were on prednisone because it alters the way your endocrine system works and your whole endocrine system has to switch back around. It could take a month or so after maybe, depending on your body. I don't think that a definite diagnosis of drug-induced diabetes is something that any doc can be sure of in your case, there is no test to weed it out, it may be just you and wishful thinking. A better diagnosis for you would be prediabetes or even diabetes as confirmed by a glucose tolerance test. In diabetes, your surgar is not always abnormal, especially as you are getting it, and if you are going to continue to take prednisone in your life and you've shown that your sugar does go abnormal, you would be better off with a regular diabetes diagnosis. This would get you your supplies and let the doctors treat you with the caution you may need, because you do tend to go abnormal with your blood sugar. It doesn't really matter why your sugar is abnormal, it still needs to be treated if it gets really bad, and docs need to know this could be a problem with you.
Most people are diagnosed with a glucose tolerance test and if you haven't had that, no one can tell if you are diabetic or not, random blood sugars and other blood tests are not accurate, despite what many docs think. My endocrinologist, who is also a diabetes doctor, told me that the only way to tell if you are truly diabetic is a glucose tolerance test and if you fail that, then you are diagnosed with diabetes or prediabetes based on a blood insulin test, which you should request from your docs to see if you are insulin resistant or not. This has to be done for you to get a proper diagnosis, otherwise they are just guessing.
My dads sugar frequently runs well over 200, 300 and he seldom notices, though his pancreas still works somewhat, he is insulin resistant though. For me, when I get only a little over 120, I start feeling really bad. I'm insulin resistant.
I take metformin because my sugar went to 180 during my glucose tolerance test and my blood insulin was very high. Metformin works well with hyperinsulinemia and it stabilizes my blood sugar at 100 no matter how much prednisone I get (I got some really big shots of it in the past).
I think you need to find another doc, due to the attitude, and probably focus less on the prednisone issue and more on whether or not you in fact have diabetes or insulin resistance in general, because you will likely be on and off prednisone, so whether it causes it or not, seems like a moot point in a way. It will also help you get the supplies you need. I have never heard of a restriction on blood sugar testing for medicare based on ICD9 codes (diagnoses) I know that medicare pays for whatever my doctor writes. Perhaps you might have better luck with the mail order people, they can communicate with the doctors office for you and get the right coding to get you what you need. I don't stick my nose in there too much, doctor's code things the way they need to be to get you what you need, everyone, including the people who work at medicare, know that the system is less than perfect and you have to fudge things sometimes so people get proper care.
I would think that you would want a regular diagnosis for this condition instead of one based on medication, since you have to take that medication fairly frequently and it may involve a nightmare of paperwork for the doctor, by having to refill it all out every time you take pred, as a totally separate condition.
Diet is very important and it is important to test not right after a meal but wait a little bit once in a while to see if the rise is just a jump or whether it stays high. Failing to eat is worse for diabetes than eating more frequently. Try googling some stuff on metabolic syndrome (prediabetes) and you will find some good information. I follow Atkins for my diabetes because my hepatologist wants me too and its the only diet where I lose weight. You will learn that certain foods are no-nos it seems, in virtually any amount, others might surprise you.
I understand a little about
the doc, just because he has to code certain ways to be able to see you often enough and test you enough and most patients trust their docs with this so I'm sure, being the Godlike person that he is, or just really busy or having a bad day, he got snippy. He probably also liked the communication he had with your old rheumy who was in his practice and feels you have made a mistake that might give you worse care, or that you feel maybe the whole practice has problems and he's next. Who knows. Maybe he's had a string of problems lately. Who knows. I hate being talked down to and treated badly, fortunately I haven't had that for a while now, last time was when I needed neck surgery and no one believe me, until they realized it might be lymphoma. It wasn't, thank God.
On the other hand, I would consider switching PCP or getting a second opinion because he sounds like he doesn't know what he's talking about
. My H1C is always normal because I am insulin-resistant (prediabetic--which means I take pills instead of insulin because my pancreas still makes insulin, too much in fact, then it will burn out and turn into regular diabetes and I will have to take shots). I would get a second opinion and explain to the new doc or even try to work with your rheumy, if he's understanding, to get a glucose tolerance test, your blood insulin tested, and a proper diagnosis instead of some temporary thing. Then you can always modify your amount of testing and treatment if need be between prednisone treatments. I just don't think anyone can prove or guarantee that it is just from prednisone, and if you mess with your blood sugar enough, you will develop regular all the time diabetes. I would also ask the second opinion doc about
metabolic syndrome (prediabetes) and treatment with pills to stabilize your sugar.
Well, I'm sorry you had to deal with the bad attitude and crap from your pcp and that you are sick. I lose all focus when they do that too and I either get made or just let give in and end up leaving the office with no answers. I really think you need to get a real diagnosis based on adequate testing. Metabolic syndrome is not something to mess around with, if you have it, and you can prevent it from turning into diabetes if you get treatment and prevent damage to your organs and other problems. I hope you get this figured out and please let us know what the result of proper testing and diagnosis is. Sending good thoughts your way!
--Doctors are men who prescribe medicines of which they know little, to cure diseases of which they know less in human beings of whom they know nothing.--Voltaire (1694-1778)
Ills--Sjogrens-Lupus-like AI Disease, Hashis, Vitiligo, spinal stenosis/fusion with plate, salivary/lymphectomies, Diabetes, NAFLD, COPD, RLS, neuropathy, trigonitis, hystero, diffuse brain atrophy
Meds--Plaquenil, Evoxac, Metformin, Synthroid, HCTZ, Estradiol patch, Prosed, Klonopin, Soma, Ultram, Vicodin, Restasis, Albuterol,steroid injections, Protopic & Triamcinolone Acetonide ointments