I've changed my diet over the last two weeks to address the high blood glucose issue. I work night, so my scheduled is opposite to most people.

There is a pattern to my readings. After fasting 8 or more hours my reading is in the 150s. At the end of the day, after eating during the evening, my readings are in the 90s. There are fluctuation, but the patter is there.

Why are my numbers higher after fasting?

-Mark-

Blood glucose is raised by steroids.

Fasting high levels, are provided by the liver in response to the fast. People developing type II diabetes often have slowly increasing fasting levels, with fairly normal daily ones in the beginning.

your A1C level is a better predictor.

There used to be a saying..."you have to eat to keep your glucose under control"...

If you have a monitor, check 1hr after eating and 2 hrs after and see what you get. People with blood sugar problems don't usually do well with fasting.

Also working nights is hard on your body, and messes up your circadian rhythms.

I usually am awakened every two or three hours to urinate during my sleeping periods, due to the Prednisone. I often take a sip of water before returning to sleep, but I could just as easily drink a bit of smoothie during these waking periods. This might eliminate the long fast.

I just sent both my neurologist and my new PCP Email about my blood glucose. I will follow up with a phone all in the afternoon, when I awake.

I am scheduled for two days of IVIG on December 1st and 2nd. My new neurologist wants to infuse every three months going forward.

I read somewhere that only 20 percent of MG patients will have a MG crises. I wonder if that statistic is a correct . I have had two MG crises events. My first MG crises was weathered home alone before I was diagnosed. Since my doctors did not see me in the MG crises state, it was not was not documented. My old PCP and my old neurologists did not hear what I was telling them when I described that first MG crises. It was like it went in one ear and out the other.

The second MG crises was well documented while I was in the hospital, and my new doctors are taking my condition more seriously. The Bible talks about the "lust of the eye," meaning that something is more real when seen. It is one thing to tell a doctor about a MG crises, but it is quite another when he or she see it firsthand. Now they know what can happen.

I've been on 1500 mg of Cellcept since mid-July. I am at the 35 mg of Predsione level for this week and the next, followed by two weeks of 30 mg, etc.

Would you expect my blood glucose levels to go down with the smaller doses of Prednisone?

-Mark-

They may eventually. You will also lose potassium and magnesium on the pred.

The frequent urination may be from the elevated glucose too...both factors.

There is a theory around that all people over 40 develop a degree of insulin resistance too. That means the receptors on the cells don't respond to insulin signals normally and the sugar remains in the serum and eventually spills out into the urine.

Make sure you are drinking enough water, and avoid dehydration too.

My diet has improved since leaving the hospital. I got a wood pellet grill that allows me to make many soft foods that I can manage with limited dental equipment and impaired jaw muscles.

I am well hydrated. I started drinking green tea. I drink 16 ounces of green or herbal tea three times a day. I also have 2 to 4 fluid cups of a chicken broth soup I make from stock from the leftover roasted chicken. I also drink water too.

With the grill I can make smoked fish and other dishes that melts in one's mouth.

Smoked Wild Coho Salmon

Smoked Wild Ahi Tuna

Roasted Chicken

Smoked Meatloaf

I made a mistake on the recipe and put the bread crumbs into the egg and spice mixture, and then mixed it into the meat. The recipe called for mixing the bread crumbs directly into the meat. The result of this mistake was a very soft meatloaf, very much like a pureed meal. The meatloaf cook at 225 degrees until the internal temperature reached 165 degrees.

I also take advantage of the convention heat on the grill and make vegetable dishes with a Dutch oven. I put a layer of large carrots at the bottom, and then add 10 sweet yellow onions cut in half. I season with garlic and herbs, and place 4 strips of bacon on top. It cooks at 450 degrees for 2 1/2 hours. The result is spectacular. I make cabbage and other vegetable combinations with the Dutch oven.

I eliminated the sweets and sugar that I started to consume after leaving the hospital. My staple is a smoothie with The Ultimate Meal, white grapes, freshly ground golden flax seeds, imported raw almonds (real raw), ginger root, blue berries (or raspberries, or black berries), few ounces of fruit juice (usually soak almond in juice overnight), kale, broccoli, cabbage, spinach, and water. I blend it in a VitaMix emulsifier, yielding 50 to 60 ounces.

I can reserve 16 ounces of this to consume during my fasting hours.

I have one third of the smoothie with breakfast, including ½ cup of oats (cinnamon and 1 tbls of brown sugar), and a cup of kefir. I have another third at mid-day, and the final third as a nightcap after work.

I also take supplements to mitigate the side effects of the Prednisone and other medications:

• Vitamin C 1000 mg
• Vitimin D3 2000 IU (I work nights and get little sun)
• Fish Oil 2400 MG
• Calcium 1200 MG
• Cinnamon 4000 MG
• Potassium Gluconate 1200 MG
• Turmeric Extract 600 MG
• Ground Flax Seeds
• Ginger Root

-Mark-

I tested my blood glucose several times in the last 24 hours:

• 2:00 p.m. 149 -- after a ten-hour fast.
• 8:22 p.m. 100 -- before eating (I was out of strips, so no reading after breakfast).
• 9:40 p.m. 103 -- 1.4 hours after eating.
• 11:00 p.m. 129 -- 1 hours after eating.
• 3:35 a.m. 104 -- after work at home -- no food for 2 or 3 hours.
• 5:00 a.m. 111 -- after night time meds, including Prednisone. I did eat during this period.
• 3:00 p.m. 147 -- had 18 oz of a smooth in three portions at 7:00 a.m., 10:00 a.m., and 11:30 a.m. -- 3 hour fast.

I take the a 35 mg dose of Prednisone with my nighttime medications, an hour before going to bed. I wonder if it is the Prednisone that increases my blood glucose? I could test this by switching the Prednisone to my daytime medications.

-Mark-

Before you do anything else try reducing
The number of smoothie snacks.
Try just one 6oz serving instead of 3.
Your daily numbers are good. One high reading
A day is not going to be damaging.
Keep track of your portions too.
A large portion of protein will be converted
To glucose too but more slowly.

Your food looks really yummy!

I got a 122 reading at 5:00 p.m. before breakfast. I will check an hour after I eat.

One hour after eating: 176

I had a 1/2 cup oats with a tbls of brown sugar and cinnamon , a cup of kefir, and 20 oz of smoothie.

The smoothies are made with 2/3 cup of the Ultimate Meal, raw almonds, ground golden flax seeds, ginger root, broccoli, white grapes, berries, spinach, and kale. I add 2 or 3 ounces of a pineapple juice, and the rest is water.

-Mark-

Mark, There is no way you can tell if you have Pred-induced diabetes or Type I or II without consulting with an endocrinologist.

I disagree that your numbers are not harmful. Yes, it is normal to have somewhat higher blood glucose up to 2 hours after eating. But your body is still having harm done to it. And there remains the possibility of a hypoglycemic drop while you are sleeping, which is dangerous!

I agree about the protein shakes. That is not sufficient protein and they have way too much unopposed sugar in them.

I am quite frustrated with this situation and implore you to consult with an endo without delay.

Annie

Dear Mark,

I agree with Annie. Your numbers are not falling within a normal range. Normal is between 70 and 100 by some guidelines, a little higher by others. Post prandial readings above 140 are not normal either.

You need to see an endocrinologist soon and determine the cause of your levels and treat them appropriately. Even if your levels are being caused by the steroids, you need to address this to prevent damage to your body systems. You may need to take a medication WITH the steroids to prevent the higher glucose levels.