Article

The aim of this study was to investigate the changes in blood glucose
and cortisol levels after glucocorticoid injections into the epidural space or
the glenohumeral joint in patients with or without diabetes.
DESIGN: Twenty-nine
patients with sciatic or shoulder pain were included. Fasting plasma glucose and
cortisol levels were measured at baseline. After glucocorticoid injection, the
levels were measured again after 1, 7, and 21 days. The patients were divided
into four subgroups according to the presence of diabetes and site of injection.
RESULTS: In all subgroups, fasting plasma glucose levels were significantly
higher 1 day after injection but returned to baseline 7 days after the injection.
Compared with baseline, cortisol levels were markedly reduced 1 and 7 days after
the injection. For both the diabetic and nondiabetic subjects, this drop was
significantly larger in the epidural injection than the glenohumeral joint
injection. At 21 days after injection, cortisol levels returned to baseline in
all subgroups except in the diabetic patients treated with epidural injections.
CONCLUSIONS: These findings indicate a need for caution when using local
glucocorticoid injection therapy in diabetic patients, most notably when an
epidural injection is given. It is also recommended that diabetic patients take
more time off before receiving a succeeding epidural glucocorticoid injection.

Langue : ANGLAIS