Corticosteroid injections pose minimal risk to diabetes patients with arthritis

Intra-articular corticosteroid (IACS) injections pose a minimal risk of accelerating diabetes for most people, despite temporarily elevating blood glucose levels, according to a study published in Clinical Diabetes.

 

Arthritis is increasing in prevalence worldwide, so glycaemic control is a concern for many receiving IACS injections.

 

IACS injections are known to cause short-term hyperglycemia, but their long-term effects on glycemic control are not well studied.

 

For the retrospective cohort study, researchers at Mayo Clinic in Minnesota used electronic health records from 1169 adults who had received an IACS injection in one large joint between 2012 and 2018.

 

They analyzed data on A1C levels for study participants from 18 months before and after the injections.

 

Researchers assessed if participants had a greater-than-expected (defined as an increase of more than 0.5% above expected) concentration of A1C after the injection, and examined rates of diabetic ketoacidosis and hyperosmolar hyperglycaemic syndrome in the 30 days following an injection.

 

Nearly 16% of people experienced a greater-than-expected A1C level after receiving an injection.

 

A1C levels rose by an average of 1.2% in the greater-than-expected group, but decreased by an average of 0.2% in the average group.

 

One patient had an episode of severe hyperglycaemia that was linked to the injection.

 

A baseline level of A1C above 8% was the only factor associated with a greater-than-expected increase in the marker after an IACS injection.