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Discussion Starter #1
There have been a few thread lately on Prednisolone which have bought some questions to mind.

1.If the side effect of taking a steroid 'can be' Diabetes
a) it can only be diabetes type 2?
b) how long before one is more suscepable
c) how can one possibly avoid it
d) why do doctors not warn people about the side effects and managment avoidance.

2. If the side effect 'Can be' an inability to produce cortisol oneself after a while lon steroids
a) how does one avoid the risk

3. How is the best taper achieved as experiences and advice differ?
a) There are thread here that suggest an every other day taper to avoid no 2. above, is this the best way?
b) Is it better to carry on with 5mg say or 2.5 well below the 7.5 natrual cortisol levels ones body produces every day?.
c) Does falling below the natrual cortisol levels avoid an cortisol failiure
d) cant remember D)!

Please I understand that none of you are doctors. Im looking for your experiences and any understanding you have discovered for yourselves.

Thanks
Nicky
 

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Here's my understanding:

(1) It's usually, if not always Type 2 or adult onset diabetes. You are more susceptible to it if you are overweight, don't exercise, etc. In my father's case... he had rising fasting blood sugar levels documented over the last several years and had all the risk factors for diabetes and the prednisone just put him right over. To avoid it, you need to control all the risk factors by eating a healthy diet, keeping weight low, exercising 30-60 minutes a day even if just a brisk walk, etc. For some of us, this is very hard to do. I *wish* I had an answer to your last question as it would have saved Dad a lot of suffering if he had been warned and more closely monitored by his GP in particular.

(2) If you have to be on prednisone to control severe disease, then it may not be possible to avoid it=body unable to produce it's own cortisol. Best way to avoid it is to use prednisone minimally, at the lowest possible dose for the least amount of time necessary. Another helpful tactic is alternate day dosing but this is usually only possible when you're on a fairly low dose (5mg or less).

(3) Trial and error can reveal the best taper process for you. That's why there's so many different options out there for reduction procedures. It's best to take the lowest dose necessary to control symptoms, and best to get off it if possible. If that dose is 5, then it's 5. Most doctors and patients would prefer 0 or 2.5 though I'm sure! Cortisol failure is most likely to occur when you take 7.5 or 10mg and higher (more likely the higher the long term maintenance dose) for LONG periods of time (more than a year or two). It is not a common event, especially given prescribing practices of doctors these days.
 

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Discussion Starter #3
Thankyou so very much Maia:)

Nicky
 
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