The short and simple version: I was on a pretty good sized dose of prednisone for several months. It did a lot of damage, but was needed as the initial treatment for a kidney problem (enlarged filtering mechanisms, the name of which I can pronounce but not spell easily in this setting). I was passing about 8K X as much protein as I should. The exact cause is/was unknown.
There can be side effects to long term use of prednisone. I gained a lot weight quickly (so much so fast I ended up having a herniated belly button which had be surgically repaired a couple years later), and got weaker. It sucked. I injured myself trying to left the same amount. FML. I used to run a lot, thinking nothing of a 10 miler in the afternoon when I got up (ahh, power shift
; day shift is the pits and as far as I concerned, French for "grievance"). After the run, it was gym time. As I got older, the running was gradually replaced with exercise bike time, typically an hour at a pop, and hard. I broke 3 in just a couple of years, and the techs would freak out at finding my warm up level. I started having terrible leg cramps at about 20 minutes, ending my rides. I whined at the doctor (a kidney specialist) and they started doing blood draws. A couple were ok, one was >400. I did not understand what that meant or why the on-call doc got her Huggies in a bunch. I had an appointment coming soon, so I waited for that to have some more chats.
At that appointment, they did a blood draw, and them my wife and I went out to dinner (at our favorite local pasta place!). I got a phone call that night from the specialist, and he put me in the hospital. My BG, BEFORE the pasta, was near 700. I spent three days on IV insulin, learning all sorts of things about diabetic care, and meeting my new specialist, the endocrinologist. (I grew to call the two of them the conspirators, but they took such good care of me and I saw them so much that I did not see my GP for two years or so and did not need to. I have nothing but positive regard for them.) As a final indignity, 3 days after I got out of the hospital I was diagnosed with a clot in my leg and ended up with 4 more days. 3 different blood thinners at one; one oral, on IV, one sub-Q. FML some more. My A1C at the time of the appointment that revealed my clot (it was all part of the diabetic education classes, which were very good) was 13.X - REALLY HIGH. I have been told by people far more savvy on medical stuff than I that the overwhelming majority of patients with such experiences would not have survived. I was merely inconvenienced. This was a direct result of my exercise program and history; I have crummy genetics. I suffered some eye damage, but it was hard to tell the additional difference between bad genes and age (I was 48). They began weaning me off prednisone and switching me to something else, a 10 month project. As I got off the prednisone, my insulin needs dropped; I now have Metformin ER (regular Metformin cleaned me out like worming a cat) as a safety matter, but most control is diet and exercise.
I was appalled by some things I saw during the diabetic education. Most of my fellow patients were in ghastly health. A guy not a lot older than I had a walker. Most were sedentary. They looked like a slow motion suicide by lifestyle group. The educators referred to 30 minutes of exercise a day - heck, that's barely a good dog walk. (An hour a day, 5X weekly is threshold minimum, for someone who is not a professional athlete or combat arms soldier. My personal exercise bikes are salt stained from sweat - I try to get to and above 90% of predicted max HR when I train.) They advocated a starvation level diet because they were so used to sedentary people - I lose weight at 3K calories/day. As soon as I was cleared, I started exercising again, which is when I broke my 3rd exercise bike. I hit a local gym and used their treadmill until I got back into running (which I had to stop again a year ago due to another darned fool injury).
I check my BG in the AM, mostly for curiosity. Any stressor will screw it up. My last 4 A1Cs (every 6 months) have been 5.9, 5.9, 5.9. 5.8. I still eat a lot, but more carefully; avoiding McDonalds and the like is important. I also exercise hard when I can. Getting enough sleep is critical. In the real world, 8 hours is barely enough for most people. I get up early now (0400) so I can take care of the dog(s) and PT a bit before work, and I try to hit the bed by 2000 on work nights. At least once a week I try to do without setting an alarm, which usually means 11+ hours of sleep. I work a high stress job and need to work that off with good exercise and plenty of sleep.
My weekend workouts are pretty hard. My wife and I both work so much that we rarely do most social things, so this is not difficult. I try for at least hard 40 minutes on the exercise bike, and at least one of three weight work outs is HEAVY, starting at sets of 4 and dropping. (I did that for years because as I cop I had to scare people out of fighting, and fight the stupid and juveniles. I was in more fights with resistors as a juvenile prosecutor than as a cop.) I can't do a full body weight workout because I lift too heavy, and have to have at least 1 rest day between weight lifting days for the same reason. I've lost all but the last 10 pounds of the weight I gained due to the prednisone, and those 10 have been slow. Right now: 6'1+, 230; 38 pants, 50 coat. I want to get back where I was (36 pants, 220, same size coat).
Get some good education about blood glucose and insulin; watch your food (intake amount and type), get lots of good hard exercise and plenty of sleep. Exercise not only uses the sugar itself, but promotes better insulin uptake.
The sweets and other starches were not that hard. You do not have to give them up entirely, you just can't pig out on them anymore. I still have a slice of bread just not the whole loaf. On pizza nights instead of eating half to three quarters of a pie it's two slices and a salad. I still eat BBQ just no sugar sauce on the meat. I still eat subs for lunch but instead of a footlong I get the double meat 6". In general I eat a lot more lean meats fish and veggies. Start buying wheat breads and whole grain stuff, the complex carbs take longer for your body to process and you don't get the spikes that the white bread and white rice give you.
