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Dr. David
Dr. David, Board Certified Physician
Category: Medical
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Experience:  Experienced Physician trained in New York City. I'm ready to help.
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My mother is 84 years old and has had polymyalgia rheumatic

Customer Question

My mother is 84 years old and has had polymyalgia rheumatic (PMR) issues for about 8 years. Her general practitioner has had her on 5 mg of prednisone a day since she was diagnosed. For flare ups, he told her she could take 5mg extra a day. Her last A1C on 7/14/16 was 6.4%. Her A1C was 5.9 on 1/13/16, 6.3 on 6/25/16, 6.1 on 12/23/14, 5.8 on 1/9/12. Suffice it to say it is gradually going up over time as expected. Because her A1C it is going up, her general practitioner scolded her on her last visit for taking a second 5mg a day for her flare ups and told her to go back to only 5mg a day. She is in another bad flare up now and must use a walker or cane to get around and takes forever to get up and get started walking because she is so stiff in her hip right now. She is a widow that lives alone. A few years ago, she was taking Fosamax for a short time to improve bone density. She just had a bone density scan that she did well on and showed she did not need to take any special measures such as Fosamax. I include this because one of the long term effects of corticosteroids is on bone density and she is doing alright in that department.
She is refusing to go to a rheumatologist so that is why I am writing you today. Her PMR is greatly affecting her daily activities and quality of life. I read online that PMR usually resolves on its own by the 6 year mark but those people were taking higher initial doses (treated more aggressively than my mother has been). If someone needs a cane or walker to get around, isn’t the blood glucose less of an issue (and treatable) than being crippled in pain. At 84 years old, if you don’t use it, you could easily lose it. I am also under the impression that untreated or under treated PMR can result in adhesive capsulitis among other things. Is the best course of action to increase corticosteroids until comfort and mobility is restored? If so, what dose plan should she follow?
Submitted: 3 months ago.
Category: Medical
Expert:  Dr. David replied 3 months ago.

This is Dr. David

taking prednisone can cause her blood sugar levels to go up and her hemoglobin a1c to go up

her PR is more of an issue than her hemoglobin a1c levels

don't let her doctors blame her

I'm sure she is trying her best on her diet.

it is her prednisone that she needs for her PR which is causing ups of her hemoglobin a1c levels

if she needs steroids for her PR to help her pain so she can continue to move around, she should take it

she should have her rheumatologist doctor call up her GP doctor about this issue.

let me know if you have other questions.

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