The Effect of Epidural Triamcinolone on the Level of Blood Glucose in the Induced Diabetic Rat

Park, Hwi; Park, Hae Jin; Cha, Young Deog; Han, Jeong Uk; Ryu, Joong Ha; Kim, Boo Seong; Lee, Sung Keun; Song, Jang Ho

Abstract

BACKGROUND
Glucocorticoids increase blood glucose levels by antagonizing the effect, and preventing the secretion, of insulin. A rare report on the change in the blood glucose level, and the effect of insulin, after an epidural steroid injection in diabetic patients, was recently cited. This study sought to evaluate the change in the blood glucose level, and the effect of insulin treatment, after an epidural triamcinolone injection in induced diabetic rats. METHODS: The basal blood glucose levels of 25 Sprague-Dawley rats were measured. The rats were njected with 50 mg/kg of streptozotocin into the abdominal cavity. After seven days, when the rats were confirmed to be diabetic, epidural catheters were inserted. The next day, the rats were randomly divided into five groups. Groups 1 and 4 were injected with saline, group 2 with 0.4 mg/kg triamcinolone and groups 3 and 5 with 0.8 mg/kg triamcinolone, through the epidural catheter. Groups 4 and 5 were subcutaneously injected with NPH, 1 U/kg, for four days, after the epidural administration. The blood glucose levels in all the groups were measured for five days after the epidural injections. RESULTS: In groups 2, 3 and 5, the blood glucose levels increased after the epidural triamcinolone injections, and yielded higher blood glucose levels than in group 1. The blood glucose levels decreased after the insulin injections in groups 4 and 5. In group 4, the blood glucose levels were lower than those manifested in group 1. In group 5, the blood glucose increased after the epidural triamcinolone injections, and decreased after the insulin injections, and also manifested higher blood glucose levels than in group 4. CONCLUSIONS: The blood glucose levels in the diabetic rats increased after the epidural injections of triamcinolone, and decreased after the insulin injections. However, the blood glucose levels in the group injected with epidural triamcinolone and subcutaneous insulin, were higher than those manifested in the group administered epidural saline and subcutaneous insulin. Increments in the insulin dose, to control blood glucose, following epidural triamcinolone injections, may be necessary.