@ FUDiabetes blog, Feb. 2, 2022
I’ve read the other contributions and your replies, Jan.
RE: conditions responding to Prednisone – there are several related in some biochemical way, but NOT the same. For me, WJM, I don’t have any kind of arthritis, not rheumatoid arthritis RA. I have PMA which can be looked up by anybody – it is far less common than RA, is somehow related to chronic fatigue syndrome et al or whatever that complement of now much more understood conditions that research medicine is constantly seeking treatments for.
I suffered severely ‘burning’ pain in ‘the skeletal muscles’ – thighs, uppermost back / shoulders / back of neck, and upper arm muscles – at first ‘we’ thought it part of my CKD Level 3B. But after careful “rule out” diagnostics, it was identified most likely as PMA polymyalgia rheumatica << not a rheumatism, but still a pervasive inflammation, I agreed (after consult w my primary care doctor AND my endocrinologist, together) to Prednisone.
As most ppl here seem to know treatment is a typified dosage at first (10 or 20mg/day to start) in USA for my age, BMI, other blood chemistries, et al). In the literature I’ve seen cases requiring nearly twice that much for their physiology / conditions. Stayed on initial 10mg/day with only very inadequate relief for a couple/three weeks; so increased to 20mg/day – which quickly evidenced itself as the dosage that worked for me – after another week or three the 20mg eliminated over 95% of my ‘episodes’.
Stayed on that for another 6-8 months when my PCP. ordered beginning of VERY GRADUAL reduction in dosage – reducing Prednisone dosage too abruptly or too fast is clinically proven to incur renewal of the inflammation and its pain! Ugh!! You do NOT want that because it apparently causes return of that acuity level that drove the patient to seek relief PLUS potentially further systemic effects (I did not learn about those…).
So am in 4th-5th month of graduated reductions - 20 to 15 to 10 and ** then I misunderstood later on so leapt to 5 when I had been told 8. So doc observed my reasonable tolerance with at last BIG JUMP - reduction of fifty percent all at once – so now I’m on third ten days of STAYING at 5mg/day, without the return of the physically disabling whole body fatigue when those initial untreated myalgia started on me.
So we will have to do as most do, taper off over a year or so longer, without stimulating return of the acute stage.
OK with me!! T1D, I CAN MANAGE – my 58th year – but that burning insides around my bones in comparison is intolerable!!
So: insulin dosing. As another contributor here clearly described – using CGM + smart hybrid pump (Dexcom G6 + T:slim X2, Novolog) adjusting basal, I:C ratio etc. with careful attention YET not reacting with pump settings until a week or more evidences that changing settings is needed.
With Tandem at least, you just duplicate your current setting, name it appropriately (to help keep track) and make the adjustment you have estimated are needed. So you do that as many times as your Prednisone dosage evidences its change in your insulin requirements ~ about 4 or 6 for me.
Pretty simple. Unfortunately also is pretty demanding. But we’re Type 1 diabetes GIANTS living in a constantly expanding FOREST of giants like us, as well as the support networks – of us as individuals and of the entire diabetes industry!
