Too Sweet

[Andrew MacLean]

The Scottish Government has introduced health checks for the over 55's. I had my 'health MoT' in the early summer and when I got back from my vacation there was a message on my machine to contact the surgery.

It seems that I was too sweet; my doctor took the view that this was a bad thing. People, she insisted, are not supposed to have so much glucose in their blood. She thinks that my prolonged exposure to steroids after my two grafts has triggered diabetes.

The good news is that the condition can be managed easily and it was discovered before I developed any of the symptoms that may be expected. My vision remains good, my feet are fine, I do not have itchy legs and I am not always running to the loo. I have to be careful of my diet and take pills to stimulate my body's production of insulin.

Nonetheless, it may be worth those who are exposed to dexamethasone or prednisolone for more than a month or two to ask if they can have their HbA1c tested.

Andrew

[matty04]

The unexpected things that arise from KC eh i was on prednisolone for my first graft in 2000 for about 10 months maybe? & i have been using Dexamethasone since last april on my latest graft each time i had an outpatients app (seeing an understudy) i would ask re the drops and told carry on using them. Will probably be looking at staying on them now as well since i'm due to have incisions soon. I am now slightly concerned thanks Andrew

[Andrew MacLean]

Matty

When I was first put on steroids I was told that there were some risks attached: they could occasion cataracts and I am pretty sure that the risk of diabetes was mentioned. To be honest I can't properly remember.

That said, I knew that there was a trade-off: the undoubted benefits to my grafted corneas of the steroids was weighed against the risks of steroid use. I did develop cataracts. I have developed diabetes, but the steroids did keep my grafts stable and enable me to recover better than normal sight. I reckon it was a no-brainer and I have no regrets. My cataract was sorted and I am living happily enough with diabetes.

It is just worth keeping an eye on HbA1c (a measurement of average blood glucose over the preceding two months or so). If it sneaks up, then it is as well to know early so that other consequences can be avoided.

Every good wish.

Andrew

[matty04]

Oh i'm 100% with you Andrew on the use of steroid drops the potential risks do not outweigh the advantages at all . I do however feel that i have been using them much longer than needed as i have had no problems with the graft whatsoever. Anyway i'm not really a worrier so whatever will be will be.....but i think i'll get it looked into

[rosemary johnson]

Gosh ANdrew! - sorry to hear that; must have been a nasty piece of news to come home to.
It doesn't entirely surprise me to hear that long term use of steroids can cause diabetes as well as all the others things they can cause (glaucoma, for example, or at least high eye pressure that puts one of risk of glaucomatose damage) but I don't recall knowing that and don't think I was ever warned of it (like amny other things I wasn't warned about!)
Glad yours seems to be under control at least.
Rosemary

[Andrew MacLean]

Thanks Rosemary.

I guess I'l spend the rest of my life attending yet another annual clinic, bleeding into their test tube and then being told either to stop eating ice cream sundaes or increase my diabetes pills.

Andrew

[sarkac]

Hi Andrew ,
I am sorry to hear that . Good thing is it is easily manageable.
Hope it does not bother you too much.
Take care

[longhoc]

As Lea has mentioned previously, I don't think that the implications of using Dexamethasone are sufficiently well explained on the Patient Information leaflets -- certainly the ones I've had accompany the medication. The problem is that the side effects are just listed in one big wodge of words in a paragraph so you don't have the data on toxicology presented in any meaningful way.

http://en.wikipedia.org/wiki/Dexamethasone#Side_effects is much more comprehensive -- including the link to diabetes (which I'd not seen before, or if I had then it didn't stick in the mind). Unfortunately the comments relate to oral or injection methods rather than eye drops, but I would guess that very long term use of drops would tend to have the same effects.

If you can find it, it's worth looking at the product manufacturers info to get the full low down on what you're taking e.g. http://www.alcon.ca/pdf/Product_pharma/ ... ex_eng.pdf -- but then again, that, like Victor Meldrew looking at the "A~Z Encyclopedia of Health " may well simply convince you you've got every malady going...

Chris

[Andrew MacLean]

This is a learning curve for us all.

I think that, some years ago, there was talk on the forum about there being no such thing as topic application of steroids. Any application to the eye becomes systemic as the drops are absorbed across the membrane of the eye or run away via the tear duct into the throat and hence to the stomach and blood.

[Amarpal]

Sorry to hear that Andrew, hope all is well with you!