Shin Woo-Yong, An Min-Ji, Im Nam-Gyu, Oh Kyung-Rok, Choe Yuri, Yoon Seo-Ra, Ryu Su-Ra
Department of Rehabilitation Medicine, Gwangju Veterans Hospital, Gwangju, Korea.
Ann Rehabil Med. 2020 Apr;44(2):117-124. doi: 10.5535/arm.2020.44.2.117. Epub 2020 Apr 29.
To investigate changes in blood glucose level after steroid injection in patients with type 2 diabetes mellitus (DM) and factors affecting those changes.
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.
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.
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.
探讨2型糖尿病(DM)患者注射类固醇后血糖水平的变化以及影响这些变化的因素。
我们回顾性研究了51例因肩痛和背痛接受类固醇注射的2型糖尿病患者。将类固醇注射前7天的平均空腹血糖(FBS)水平作为基线血糖水平,并与类固醇注射后14天的FBS水平进行比较。我们比较了糖化血红蛋白(HbA1c)>7%组和HbA1c≤7%组之间以及胰岛素治疗组和非胰岛素治疗组之间血糖变化的差异。分析了人口统计学数据、注射部位和类固醇剂量。
与基线相比,类固醇注射后1天血糖显著升高(p = 0.012),但注射后2天未升高。在HbA1c>7%组和胰岛素治疗组中,注射后1天的血糖分别比HbA1c≤7%组(p = 0.011)和非胰岛素治疗组(p = 0.024)显著升高。注射前较高的HbA1c水平与注射后1天血糖升高的程度显著相关(p = 0.003)。根据注射部位或类固醇剂量,血糖升高程度无显著差异。
较高的HbA1c水平与类固醇注射后1天血糖的更大升高有关。对于血糖控制不佳的糖尿病患者,在类固醇注射后的第一天需要仔细监测血糖。