Changes in Blood Glucose Level After Steroid Injection for Musculoskeletal Pain in Patients With Diabetes

Abstract

Objective To investigate changes in blood glucose level after steroid injection in patients with type 2 diabetes mellitus (DM) and factors affecting those changes.Methods We retrospectively studied 51 patients with type 2 DM who underwent steroid injection for shoulder and back pain. Mean fasting blood sugar (FBS) levels for 7 days before steroid injection was used as the baseline blood glucose level, which was compared with FBS levels for 14 days after steroid injection. We compared the differences in blood glucose changes between HbA1c >7% and HbA1c ≤7% groups and those between insulin and non-insulin treated groups. Demographic data, injection site, and steroid dose were analyzed.Results Compared to baseline, blood glucose significantly (p=0.012) elevated 1 day after steroid injection but not 2 days after injection. In the HbA1c >7% and insulin groups, blood glucose was significantly increased 1 day after injection compared to that in the HbA1c ≤7% (p=0.011) and non-insulin (p=0.024) groups, respectively. Higher HbA1c level before injection was significantly (p=0.003) associated with the degree of blood glucose increase 1 day after injection. No significant differences were noted in the degree of blood glucose increase according to injection site or steroid dose.Conclusion Higher HbA1c level was associated with greater elevation in blood glucose 1 day after steroid injection. Careful monitoring of blood glucose is required on the first day after steroid injection in patients with poorly controlled DM.

Effectiveness of Shock Wave Therapy versus Intra-Articular Corticosteroid Injection in Diabetic Frozen Shoulder Patients’ Management: Randomized Controlled Trial

“…The present study's results were in contrast with other retrospective study with relatively small sample size that concluded that steroid intra-articular injection led to greater elevation in blood glucose one day only after steroid injection [45].…”

The effect of steroid injection into the shoulder on glycemia in patients with type 2 diabetes

“…This is based on the previous studies that showed more prominent glycemic changes in the first 3 days after the steroid injection. 12 , 25 , 26 …”

“… 5 , 12 , 30 The literature contains only a few prospective studies, with a small number of participants, assessing the effect of local corticosteroid injection to the shoulder on glycemia. 2 , 13 , 20 , 26 , 29 , 30 These studies have shown a mild increase in average blood glucose levels after shoulder intra-articular corticosteroid injections. 2 , 13 , 20 , 26 , 29 , 30 However, all these studies used a small number of glucose measurements carried out in each patient, which does not necessarily represent the patient’s glucose levels after the injection.…”

“…2 , 13 , 20 , 26 , 29 , 30 These studies have shown a mild increase in average blood glucose levels after shoulder intra-articular corticosteroid injections. 2 , 13 , 20 , 26 , 29 , 30 However, all these studies used a small number of glucose measurements carried out in each patient, which does not necessarily represent the patient’s glucose levels after the injection. None of these studies analyzed the effects of injected local corticosteroids continuously throughout the study period.…”

Frozen shoulder

“…Another reported that, of 133 participants, one patient (0.7%) experienced prolonged pain at the injection site, and three patients (2.3%) developed transient facial flushing 24. Steroid injections can affect blood glucose control in patients with diabetes, particularly in the first day after the intervention 25…”