Hi there! I have been on 30mg MTX for the past two years... however, I have now developed Diabetes... which my Diabetes Educator is convinced has been triggered by the MTX... My GP thinks it's all nonsense, since there is no mention of diabetes in the MIMS, so I'm wondering if anyone else has had this happen to them?
I don't know of any connection with MTX specifically but what I would say is that diabetes is a known co-morbidity of PsA, so it may be the disease not the treatment affecting you.
A graphic was posted on here recently with some stats showing that 42% of PsA sufferers have three or more co-morbidities (cardiovascular disease, diabetes, obesity, Crohn's disease, lupus and other autoimmune diseases). I think the diabetes connection with PsA is now often referred to as metabolic syndrome.
MTX doesn't cause dibates. Your diabetes educator should concern herself with helping you live with another autoimmune disease in addition to the one you have instead of instead of trying to blame you or your docs for you having it. It prolly wouldn't hurt if she'd learn a little about PsA.
Actually now that I think about it, I'd fire her ass in a New York minute and push her facility to do the same. Her job is to help you live with another disease, not cause you more trouble concern or stress. Especially going well beyond her expertise and training.......
I have been through this and know that Methatrexate can cause a rise in blood sugars and if you were already hyperglycemic it is possible this could tip you over into type 2 diabetes
That is correct however their is little evidence that even on high dose MTX that rise exceeds 10 points. MTX is used with existing Type 1 and type 2 diabetics routinely.
Allan said:
I have been through this and know that Methatrexate can cause a rise in blood sugars and if you were already hyperglycemic it is possible this could tip you over into type 2 diabetes
Allan said:
I have been through this and know that Methatrexate can cause a rise in blood sugars and if you were already hyperglycemic it is possible this could tip you over into type 2 diabetes.
I was changed to leflumonide, was more careful with my diet and made an effort to do more simple exercise and my sugars dropped back to near normal
Thank you all so much for your helpful and informative replies. I really appreciate your knowledge, as I sometimes feel overwhelmed by all the stuff that life throws at me!!
Cheers
:)
It always concerns me when a doc writes off something like this when there is plenty of information indicating great care should be taken for a PsA suffer with diabetes and taking Methorexate because of the the possibility or increasing blood sugars and the greater chance of developing severe liver fibrosis.
I shall have to ask Dr Google about all this.... I've never heard of Metabolic Syndrome... Thanks Jules :)
Jules said:
I don't know of any connection with MTX specifically but what I would say is that diabetes is a known co-morbidity of PsA, so it may be the disease not the treatment affecting you.
A graphic was posted on here recently with some stats showing that 42% of PsA sufferers have three or more co-morbidities (cardiovascular disease, diabetes, obesity, Crohn's disease, lupus and other autoimmune diseases). I think the diabetes connection with PsA is now often referred to as metabolic syndrome.
I have had back problems for about 15 years now... I have always complained of having additional joint pains and been told it was
(a) psychosomatic
(b) Polymyalgia Rheumatica
(c) because I was overweight and unfit... although I'm not too sure how this affected my elbows and neck... *scratching head*
When the skin symptoms started, it was generally thought it was either an allergy to a medication or that is was because I had been suffering from anxiety...(is it any wonder??)
It wasn't until I saw the dermatologist that he HE pointed out that I have psoriasis and that it causes joint pains ... so he started me me on the MTX after trying lots of different skin creams which had absolutely no effect whatsoever!! He has talked vaguely about starting me on "biologicals" but since I at least knew what MTX was, and had no idea what these "biologicals" were, I went with the MTX... now I'm wondering if I should be seeing a rheumatologist instead? I have been seeing a multidisciplinary pain management clinic for years, but they are only interested in my back problems and not any pains I get anywhere else...
It's always one step forward and three steps sideways....
Allan said:
It always concerns me when a doc writes off something like this when there is plenty of information indicating great care should be taken for a PsA suffer with diabetes and taking Methorexate because of the the possibility or increasing blood sugars and the greater chance of developing severe liver fibrosis.
I would definitely recommend seeing a rheumatologist. In my case I have moved onto the biological Enbrel and no longer have the high sugar levels and, combined with weight loss, both my psoriasis and PSA are pretty much under control.
I am on the hunt now for relevant articles.... and found this one on Medscape... http://www.medscape.com/viewarticle/576496_5
Which is about people with Psoriasis being more susceptible to atheroschlerosis, heart attack and other issues associated with Metabolic Syndrome....
Jules said:
I don't know of any connection with MTX specifically but what I would say is that diabetes is a known co-morbidity of PsA, so it may be the disease not the treatment affecting you.
A graphic was posted on here recently with some stats showing that 42% of PsA sufferers have three or more co-morbidities (cardiovascular disease, diabetes, obesity, Crohn's disease, lupus and other autoimmune diseases). I think the diabetes connection with PsA is now often referred to as metabolic syndrome.
Thank you Allan... I will see about a referral... The pain clinic put me on Gabapentin for my neuropathic pain (which I'm thinking now was probably PsA all along!) several years ago and I gained 40 kg in 4 years before someone had the heart to tell me that it's a drug that stimulates your appetite AND slows the metabolism... now I'm trying to (slowly) shift some of it again.... Hey Ho!
Allan said:
I would definitely recommend seeing a rheumatologist. In my case I have moved onto the biological Enbrel and no longer have the high sugar levels and, combined with weight loss, both my psoriasis and PSA are pretty much under control.
I disagree with MTX being the root cause of diabetes. People with psoriasis tend to have more issues with liver complications (independent of diabetes) than those who do not. However, it’s good practice to make sure your BS is stable before using any of the typical DRAMDs and including the biologics.
I can see I have a lot to learn!
Thanks :)
mataribot said:
I disagree with MTX being the root cause of diabetes. People with psoriasis tend to have more issues with liver complications (independent of diabetes) than those who do not. However, it's good practice to make sure your BS is stable before using any of the typical DRAMDs and including the biologics.
Sorry for the thread resurrection, but I have one last thing to say. I would avoid using NSAIDs (Asprin etc…) until you have your BS stabilized. With many diabetes medications it possible to drop your BS to low and taking a NSAIDs could further complicate that problem. I’d talk to your doctor before using NSAIDs daily. This is just my opinion. Make sure to talk to your doctor before changing anything.
Good point martibot. The other issue with NSAIDs though, particularly Ibuprofen, is that their use with Gabapentin should be restricted if possible anyway as they can increase the effects of the med (not in a good way) Gabapentin as you know is a pro-drug, great in that is not metabolized leaving the kidneys and liver alone, bad in the fact it becomes a part of the system allowing water retention and increased blood sugar.
I have to agree with Lamb an Mataribot in that I have never heard of diabetes being a side effect of MTX. Before starting MTX (or any drug, for that matter) I do some very thorough research, and this is definitely something that would have some up in my search.
I would suspect other culprits, such as the PsA itself, any prednisone use, Gabapentin, or if one is overweight and inactive before I would look to the methotrexate as a cause.
The sad thing is that none of my doctors monitor for Diabetes. I have to ask them to monitor for it by requesting a test. Seems silly to me that they don’t care about it. I’m not sure what the big deal is with testing every other year is, but they argue every time.
That’s not right. They should AT LEAST be doing a yearly fasting serum glucose test with your physical.