Has anyone here developed Pre-Diabetes during Hormone Therapy
I see BCO has an article about this
https://www.breastcancer.org/research-news/link-between-hormonal-tx-and-diabetes
My story so far - after always having fasting blood sugar in the 80s or even the 70s, my last two readings at the oncologists office, three weeks apart, were over 100. The first time, I had a smoothie not long before I left but the second time I really was fasting.
So, I decide to monitor at home and sure enough, my fasting blood sugar has consistently been 99 to 110.
I’ve done the one hour and two hour after meal tests and those readings are what they should be, which seems strange to me.
I eat low carb, but I do not exercise regularly anymore. I have been on Arimidex three and a half years.
I do intend to get an appt with my PCP. But just wondering what experience other people may have had with glucose readings, prediabetes and hormone therapy.
Thanks
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Have you had your A1c tested? That's what determined my pre-diabetic, and later diabetic, diagnosis (both before breast cancer, so not from medications).
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Last A1C test I had was four years ago so will definitely need my PCP to do complete blood work. Thanks for the tip
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Yes, I couldn’t tolerate Tamoxifen. My A1C was 5.0 in May 2020, jumped to 5.7 by October. I started Tamoxifen in July. I previously had low (normal) blood sugar levels and fasting was low 70s in 2018. Since stopping the med, I now follow a carb restricted diet because my blood sugar would not go back down to pre Tamoxifen levels without dietary changes. I started having huge spikes to 200 while on Tamoxifen and still need to watch what I eat
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Wow. Sorry to hear that and thank you for sharing. Stupid cancer always puts us between a rock and a hard place
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Well I too have been taking the hormone therapy for 3 years. My fasting blood sugar is mostly always over in the 110-120 range. Had 1st A1C done in 2019 and it was 5.9%. I am going tomorrow for bloodwork and I hope that number is the same or less but I don't have a great track record on passing tests. My mother had diabetes. Years ago 120 or lower was considered normal but they have since lowered the bar to 100. I also think my readings were like this years ago which was prior to the bc diagnosis.
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Yeah, we have a few cases of Type 2 in my family, that’s why Ive always worried and kept a glucose monitor at home. But I have been extremely lucky up til now. Even when my weight and carb consumption were not optimal, I was getting good readings.
Yes, under 100 is considered normal now. Even up to 130 used to be considered “okay”. Definitely gonna get the A1C checked too
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I pulled out my medical file to look for something else but I checked my PCP visits while there - he did an A1C in 2018, so three years ago actually. Result was 4.5. Very interested to see wha my next one will be.
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I am in the boat with you. My blood sugar increased to pre-diabetes levels about 1.5 years after starting tamoxifen and was still high this year. Last year my A1C was still beneath the threshold, but this year it crept just above. My mother had diabetes so I am stressed about the possibility. I am not heavy, exercised a lot, so I have done some diet changes and hopefully will bring it back down. As a happy side effect, I have lost a few pounds so now I weigh less than my daughters. Overall, I have been freaked out and discouraged by the finding.
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My fasting glucose was 123 today, A1C has remained the same 5.9%. Still on the verge I would say. Cholesterol is different story. I'm just guessing doc will increase my statin from 10mg to 20. I go in a couple weeks.
Interesting enough, anastrozole is metabolized in the liver, so is this family/lifestyle related or will increasing my meds might help shut down some of this bad cholesterol as it's possible this hormone therapy is the cause?
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Yeah, these numbers are not super high yet so I'm hoping this is something that can be controlled with exercise and continuing my low carb lifestyle. I was doing daily walks and light exercise regularly until the Covid lockdowns and just have not gotten back in the routine. I know my onc will not want me going off AIs and the other types of estrogen therapy have the same effect so I guess adjusting meds is not a possibility for me.
Adding, I am not on cholesterol meds at this time either. My numbers were high normal but my cardiologist says they should be lower. But again, I need new bloodwork...maybe I’m now higher than beforeI called to make an endocrinologist appt today - I am overdue for a thyroid follow up (nodules, not diagnosed as serious, but we are watching) so I told the nurse about my blood sugar concerns and she said well really, if glucose is under 120 it's not too concerning, but the doctor will want to see your A1C and other bloodwork.
That appt is not until November though, so will talk to both my onc and PCP right away. Thanks for sharing ladies
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hi olma, have you considered meeting with a dietician? Maybe that would be helpful also. Good luck at your appts
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Hi Olma,
Along with dietary changes, my doctor says that EDTA chelation therapy will help reverse it. If you have an integrative/functional medical doctor near you for a consult, they should be able to tell you more. You can also find one from acam.org.
Blessings to you,
Esther
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Thanks so much, I truly appreciate your suggestions ladies. Xox
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Interesting article came across my Facebook feed. The connection between fatty liver and type 2 diabetes is over-secretion of GABA enzyme. Researchers are testing a drug to inhibit GABA secretion. Trials are just starting so this drug, if it works, is a long way off. Now I wonder if I have developed fatty liver.
https://news.arizona.edu/story/promising-new-pathway-treating-type-2-diabetes
My FB friend who posted this is skeptical of *some* pharmaceutical interventions. She commented with a study on dietary changes. Keto diet, I think,but haven't taken time to read it yet.
https://bmjopen.bmj.com/content/9/2/e023597
Still gonna need all my bloodwork...I am just worrying out loud here. And trying to share whatever helpful info I find0 -
Hi Olma,
Yes, diet is huge. My aunt turned around her pre-diabetes with diet alone, and it never came back. I'd avoid drugs if possible because so many safer options are available, including chelation therapy. If I see a good link, I'll forward it to you.
Blessings,
Esther
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Olma,
Also, if you have been low carb for a few years or so, some people note an adaptation by their body such that fasting glucose increases but their A1C does not because they have better blood sugar control over the course of the day. So, it is thought that the fasting glucose being a bit high is ok in this case. There is a keto diet thread that you could check out on this board, I'm not sure if it's mentioned anywhere in that thread. I have read about this, I purchased a CGM when I saw my blood sugar getting out of control and belong to a Facebook group for CGM users. There are some healthy low carb folks who have a somewhat elevated fasting glucose but their A1C is normal and they have good blood sugar control.
I agree with the statement about good diet, it has required some experimentation on my behalf - ultimately, it's what you eat and your muscle composition that matter, but mainly the diet. There are definitely individual differences between people re: what they can tolerate. I was hovering around 105 in January, I just checked and I'm at 89 at 8:45 AM. But this is after I've been up for a while. I experience the "dawn effect" where my level rises in the early AM to the mid to high 90s, but comes down after I'm up for a bit. I am not keto but I have cut back my carbs substantially and now emphasize weight lifting in my exercise regimen so that I have more muscle to absorb more glucose.
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PAKNC - thanks so much for your reply. Great information. My sister who does have Type 2, controlled with metformin, also suggested weight training.
Did you need a script for a CGM or are they otc now?
I will check out the keto thread here for sure. I follow a couple of FB groups for keto and IF. Some of the people there eat under 20 carbs a day and I dont think I could do that forever because it means even cutting vegetables down to a very bare minimum. I put 125 g as a carb goal in my tracker and most days I am well under. Around 50 or 60 grams is more doable. I do usually avoid the high glycemic stuff, bread, etc, but lately I was eating more sugary fruit, which I will cut out and see what happens.
I learned so much from the Blood Sugar 101 website, that’s how I learned how to track and do the after meal tests. I’ve used that as a reference for years now.
I’ve been having increased neuropathy in my feet which certainly could be related to the cancer drugs I’m on, but that still worries me. I don’t think these glucose numbers have me at the point of nerve damage but I’m still a little obsessed over it.
Take good care everyone and have a good weekend
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I bought the CGM myself because my PCP wouldn't prescribe one for me because I'm not a diabetic yet. And I'm so glad that I did because for me, there's nothing more powerful than instant feedback. I did a 3-month plan at the outset with remote support from a dietician the first month, and joined a Facebook group for the CGM users. I then moved down to a twice a year plan so I can get the 24/7 view in December and June. I was shocked that my blood sugar was spiking to over 200 after certain meals, and what triggered it. Things as simple as having chicken brats with condiments (which had added sugar but low calories). I thought I was eating healthy when I was not, for my metabolism. I would never have understood the patterns without the CGM. It is expensive but to me, worth it.
Similar to you, I'm not keto and would rather not remove all carbs because I will feel too deprived. I have cut my bread intake way back - maybe once/week. I allow myself grace on Friday's and vacations, and don't beat myself up about it. Also, there are "tricks" that you can use to keep the blood sugar from spiking so much, by incorporating more protein and fat in the meal, for example. What I was told is that the spikes are more damaging than a steady glucose level in the low 100's, for example.
I started getting nerve pain last summer, and now have some neuropathy in my hands and feet - I'm not sure if it's related to my scoliosis pressing on the nerve or not. I recently was able to eliminate the nerve pain in my shoulder but it shifted then to my foot - so annoying. I do have to wonder too if this started happening due to the damage to my blood vessels and nerves from the blood sugar spikes.
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👍🏼 thanks for the CGM info. Turns out I was wrong about how soon neuropathy can set in from impaired glucose processing. According to my favorite website, it can occur in pre-diabetes and is often a first sign that leads to a diabetes diagnosis.
Quote:
Neuropathy Means "Sick Nerves"
It is an early complication of diabetes which starts to occur in people who have blood sugars most doctors dismiss as "normal" or "mildly prediabetic."
Because nerves are damaged by the "mildly" elevated blood sugar levels that most doctors ignore, almost one half of people with Type 2 diabetes already have detectable neuropathy by the time they have been diagnosed with diabetes. Many other people who are never officially diagnosed with diabetes but have higher than normal blood sugars also get "diabetic" neuropathy. It may be a major cause of the impotence so common among men in their 40s and older.
https://www.bloodsugar101.com/you-can-heal-diabetic-neuropathy
on a happier note, my reading this morning was 95...and before bed last night after a four hour fast it was 96So maybe the small changes I've made in two weeks are making a difference. Encouragement to keep going!
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This is a great web site, thanks for sharing it
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Glad you like it, yea I find it a great source. Here’s an article I found about metabolic syndrome and hormone therapy. It’s from 2010 but I suppose it’s still relevant.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2821047/
meanwhile, I was looking at my recent bloodtest results last night. My Alk Phos is on a steady trend upwards. Still in normal range but has been heading in a straight line upward for months now. For me, that could mean new mets, but could also be something else going on. Next scan will be soon, so I’ll wait and see.0 -
I started pre-diabetes in my 40s, well before breast cancer. I'm surprised I didn't turn full fledged diabetic with the meds. My weight has crept up and so has my fasting, but still pre-diabetic range. I still think my thyroid is messing with me, LOL.
Normal range standards used to be 110 or below, now it is 100. Last I was practicing, Europe kept with the 110, so that may have changed.
Anything over 125 on two fasting results is considered diabetic.
Keto diets can increase A1c in some individuals, even if the fasting number is lower.
and this: https://care.diabetesjournals.org/content/29/6/140...
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Wallycat, good info, thanks! Speaking of thyroid yeah I have nodules and also, hypertension which I've had forever, but only started medication four years ago. Funnily enough, the doctor put me on Telmisartan for my BPwhich is supposed to also help with high cholesterol and insulin resistance. But maybe those readings would be worse if I wasn't on it.
Are you takingany meds due to the prediabetes? I was thinking I wouldn't mind going on Metformin, since it might help take off some weight and it's said to have possible anti-cancer properties.0 -
I have begged for metformin and my onco has rejected it, mainly because she says some of the side effects are unpleasant (yeah, like the tamox and AIs are a joyride).
Some blood pressure medication can raise blood sugar but the one you are on does not appear to cause that in a significant way.
I finally found a PCP. I will see her in August and will ask for a beta blocker and discuss metformin. That combo can sometimes kill cancer cells....but beta blockers are not first line of BP meds. My bp is usually normal/low but after my covid vaccine, it seems to be all over the map.....
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Good, I hope you do get those drugs. When I was first diagnosed, I had read about beta blocker / breast cancer studies and here's another newer one with Coreg:
https://www.monash.edu/news/articles/cardiac-drug-could-reduce-breast-cancer-spread-and-mortality
I told my onc about this at the time, she said “oh yeah that's a good cardiac drug. But stay on Losartan for now."
Today was my onc appt. I told the NP about my glucose concerns -
“Last time I was here my fasting glucose was 108"
“Oh, that's good, that's not bad!"
¯\_(ツ)_/¯
It's like pulling teeth sometimes. I had to go in to the whole story, “ it's not a good reading for me, because I've always been in the 80s etcétera etcétera “. Im anticipating every other MD to tell me it's not bad to be over 100 - with neuropathy!
Anyway, I was able to get an appt for the end of August with a different endocrinologist and Im gonna try to see my new PCP ASAP.
I did have a reading of 94 this morning hooray hurrah. And I'm getting a lot of steps in.
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It's encouraging to see that some with pre diabetes for years have not progressed to diabetes with minor changes to lifestyle. I've read some statistics that scared me indicating that most pre diabetics will turn diabetic, and fairly soon, if they don't make adjustments to lifestyle.
Olma, I understand where you're coming from with the doctor discounting your concern. One of the learnings that I got from the CGM was to see how my blood sugar stayed elevated overnight if I had a sugary snack after 8 PM. My fasting blood sugar was still ok when I got up, but for most of the night, it was in the 120's because I'm impaired. I think these are the types of habits that can eventually turn a person diabetic. So, simple changes can make a big difference - have the sugary snack earlier in the day when you are more insulin sensitive, if you're going to have it, for example. If you still have concerns over time, you could buy a CGM, or set your alarm for 3 AM and see what your blood sugar is doing. However, in my case, it seems that once I get up, it always falls.
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Yes, PAKNC, good suggestions. I have made the effort to refrain from eating three hours or more before going to bed. I've started taking a reading before bed and my readings at night, 3 or more hours after eating, are lower than the ones in the morning. Been getting 88 to 95 at night - yes one 88, while I have not seen a morning reading in the 80s since starting this three weeks ago. So the issue of higher glucose upon waking might be part of what I am experiencing.
Here's an article in Diabetes Journal arguing against Metformin for pre-diabetes:
https://care.diabetesjournals.org/content/43/9/1983
It also says this, which I find interesting:
“First, approximately two-thirds of people with prediabetes do not develop diabetes, even after many years. Second, approximately one-third of people with prediabetes return to normal glucose regulation. Third, people who meet the glycemic criteria for prediabetes are not at risk for the microvascular complications of diabetes and thus metformin treatment will not affect this important outcome. Why put people who are not at risk for the microvascular complications of diabetes on a drug (possibly for the rest of their lives) that has no immediate advantage except to lower subdiabetes glycemia to even lower levels?“
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Just saw this thread, and reading through the posts, I find it interesting how often diabetes, blood pressure and thyroid disorders seem to cluster together with BC. Anyway to answer the question of the the post, I was pre-diabetic before AI's, with a fasting glucose around 115-120 or so. This year the fasting went up, ranging from 130-145, and post meal spikes sometimes around 250. My A1C is not yet in the diabetic range, but I started metformin to level out those spikes. Maybe the AI's are directly to blame, or maybe it's the lack of exercise and weight gain since my diagnosis that have affected my insulin resistance.
Wallycat, I fully expected to have terrible side effects on metformin, but I have almost none after the first few days. I actually feel better on metformin. I can't handle the beta blockers however- they make me feel like a sloth all day.
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Whatjusthappened thanks for adding your experience to the thread! Good point about the metabolic trifecta of hypertension, thyroid and diabetes. My sister developed exactly that syndrome at a pretty early age - late 30s / early 40s. She's been under control with medications the entire time and has not had to use anything more than metformin for her diabetes, thankfully. She does exercise regularly but is less careful about her diet.
For me, the high blood pressure came on in my late thirties. My thyroid has always looked a little enlarged, but bloodwork was always perfect, as were all my other vitals for a long time. My cholesterol creeped up a bit but even though my cardiologist would like it lower, it's only a couple of points outside normal for total cholesterol and my triglycerides arenormal so no meds for that. Thyroid nodules only diagnosed within the last two years. In sum, the “trifecta" May be developing more slowly than for my sister but possibly, I may be inching towards it.
I'm on vacation so not posting as much as usual, and also, not doing my daily finger sticks and readings. Before I left I ordered a home A1C test that you send out to a lab. They test a few other markers as well. I was interested in seeing the result since my MD appts are still a few weeks off.Got a colonoscopy scheduled for 8/31 too. My first. Ugh not looking forward to it but I guess I'll put on my big girl pants and deal with it ( til I have to take them off for the procedure) 😂😂
As someone who always avoided the doctors office, I sure do get to go there a lot nowadays (eyeroll)
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