*MY* personal observation is the pain increases
bg's. I've had cortizone shots it's not raised me as
much as when my back pain is high. But again, I"m
unable to measure how much natural coritzol i'm
letting out.

When I have a RA flare, my bg's go high, and it always higher when I'm
on pred. This may be another YMMV thing too. Don't we have
fun?!?......Mic

Always, be, and stay AWARE!

  You supplement your natural insulin supply in two ways:

 1.  Use oral meds like Glyburide,  Glucovance, Gliclizide, Prandin,
Starlix etc which force your beta cells to churn out extra insulin.

Many of us define the beta stimulator pills as a form of supplementing or
augmenting your natural insulin supply because taking them results in more
insulin in your blood than your natural regulatory system would otherwise
generate.    Of course, if you are diabetic or even IGT,  your natural
regulatory system is damaged and doesn't put enough insulin into your blood
without some form of outside help/stimulation so fiddling with the pills can
improve bG control.

The Prandin and Starlix are short-lived beta stimulators so they usually
don't cause problems with low bG at night.   However,  the sulfonylureas
have a tendency to force your betas to crank out extra insulin for hours
after you really need the stimulation and folks using sulfonylureas do go
low at times.

 2.  You also can supplement your natural insulin supply by taking shots of
insulin.

One of the more common supplemental insulin regimes for an IGT   (yes,
there are very good reasons for giving IGT insulin shots)   is an injection
of an insulin called NPH insulin one or more times a day.   It is cheap,
stable,  available without prescription,  and can do a very good job.
However,  take too big a dose at bedtime and you can go low 4-6 hours later.
That's why the docs want NPH shooters to check their 3 am bG now and then.

Some doctors, like Bernstein for instance,  favor going to insulin really
quickly instead of fiddling with the beta stimulator pills.   The pills are
cheap and convenient but they are thought to encourage early "burn out" of
the diabetic's already-damaged beta cells.   That means an easy time now,
but a more severe form of diabetes later on.

They give insulin to IGT folks in hopes that it will delay the Standard Type
2 Diabetic Progression, i.e.  delay your progression from IGT to frank Type
2 diabetes.   The odds are almost 100% that an IGT will progress to Type 2
if he is IGT long enough.

Prednisone usually sends diabetic bG soaring.  If you are IGT and need
periodic prednisone,  the odds are that you will need some sort of "help" in
controlling your bG sooner or later.    Insulin injections are one option.
The insulin option is a Royal PITA but some docs feel it is the option which
maximizes protection of your self-generated insulin system.

Prednisone has a nasty reputation for somehow damaging our self-generated
insulin system.   You might want to sit down and talk with your
Rheumatologist and perhaps an endocrinologist and plan your future.
Anything you can do to avoid ending up like me  (totally defunct
self-generated insulin system) is, IMHO,  worth it.

Regards
 Old Al