Ann Rehabil Med.  2020 Apr;44(2):117-124. 10.5535/arm.2020.44.2.117.

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

• Shin WY
• An MJ
• Im NG
• Oh KR
• Choe Y
• Yoon SR
• Ryu SR

• KMID: 2501055
• DOI: http://doi.org/10.5535/arm.2020.44.2.117

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.

Keyword

Steroid; Blood glucose; Type 2 diabetes mellitus

Figure

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  Fig. 1. Flow chart of study subjects.

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  Fig. 2. Total average fasting blood sugar after injection. This figures shows mean fasting blood sugar (FBS) level was significantly elevated at 1 day after steroid injection compared to baseline FBS, but not significantly increased at 2 days after steroid injection. a)Statistically significant (p=0.012) in comparison between baseline and after 1 day. b)Statistically significant (p=0.000) in fasting blood glucose after steroid injection over time using repeated measures of ANOVA.

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  Fig. 3. Change in fasting blood sugar (FBS) level after injection in the HbA1c >7% group versus the HbA1c ≤7% group. This figure show the HbA1c >7% group had a significantly higher degree of FBS increase 1 day after steroid injection than did the HbA1c ≤7% group. *p<0.05.

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  Fig. 4. Change in fasting blood sugar (FBS) level after injection in the insulin group versus the non-insulin group. This figure shows that the insulin group had a significantly higher degree of FBS increase 1 day after steroid injection than did the non-insulin group. *p<0.05.

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