Blood Glucose Levels in Diabetic Patients Following Corticosteroid Injections into the Subacromial Space of the Shoulder

Background: Corticosteroid injections are used to treat a variety of orthopedic conditions with the goal of decreasingpain and inflammation. Administration of systemic or local corticosteroids risks temporarily increasing blood glucoselevels, especially diabetic patients. The purpose of this study is to quantify the effects of corticosteroid injections onblood glucose levels in diabetic patients with shoulder pathology.Methods: Diabetic patients who regularly monitored their blood glucose levels and were indicated for a subacromialcorticosteroid injection were included in this prospective investigation. The typical normal morning fasting glucoseand most recent hemoglobin A1c level was recorded for each patient. After injection, patients were contacted daily toconfirm their fasting morning glucose level for 10 days post-injection.Results: Seventeen consecutive patients were enrolled. Patients with hemoglobin A1c of <7% had an average risein blood glucose of 38 mg/dL compared to 98 mg/dL in the poorly controlled group after injection (P<0.001). Wellcontrolledpatients’ glucose levels returned to near baseline levels around post-injection day 8, while poorly controlledpatients levels remained elevated. Similarly, insulin-dependent diabetic patients had an average increase in fastingglucose level of 99 mg/dL versus 50 mg/dL in non-insulin-dependent diabetic patients (P<0.001).Conclusion: After corticosteroid injection, patients with well-controlled diabetes experience smaller elevations andfaster return to baseline glucose levels than patients with poor control. Insulin dependent diabetics experienced similarfindings as patients with poor control. Future studies are needed to evaluate dosing to optimize the risks of bloodglucose elevation while maintaining therapeutic benefit.

Keywords:

Corticosteroid injection , Diabetic response to corticosteroid injection , Glucose response to corticosteroid , Pain relief with steroid injection , Shoulder injection , Shoulder pain