title: Blood glucose levels in diabetic patients following corticosteroid injections into the hand and wrist.
abstract: OBJECTIVE
  To quantify diabetic patients' change in blood glucose levels after corticosteroid injection for common hand diseases and to assess which patient-level risk factors may predict an increase in blood glucose levels.
  
  
  METHODS
  Patients were recruited for this case-crossover study in the clinic of fellowship-trained hand surgeons at a tertiary care center. Patients with diabetes mellitus type 1 or 2, who received a corticosteroid injection, recorded the morning fasting blood glucose levels for 14 days after the injection. Fasting glucose levels on days 1 to 7 after injection qualified as case data; levels on days 10 to 14 provided control data. A mixed model with a priori contrasts was used to compare postinjection blood glucose levels with baseline levels. We used a linear regression model to determine patient predictors of a postinjection rise in blood glucose levels.
  
  
  RESULTS
  Of 67 patients recruited for the study returned, 40 (60%) completed blood glucose logs. There was a significant increase in fasting blood glucose levels after injection limited to postinjection days 1 and 2. Among patient risk factors in the linear regression model, type 1 diabetes and use of insulin each predicted a postinjection increase in blood glucose levels from baseline, whereas higher glycated hemoglobin levels did not predict increases.
  
  
  CONCLUSIONS
  Corticosteroid injections in the hand transiently increase blood glucose levels in diabetic patients. Patients with type 1 diabetes and insulin-dependent diabetics are more likely to experience this transient rise in blood glucose levels.
  
  
  METHODS
  Therapeutic III.
authors.affiliation: Department of Orthopaedic Surgery, Washington University School of Medicine in St. Louis, St. Louis, MO; Washington University School of Medicine in St. Louis, St. Louis, MO; Washington University in St. Louis Institute of Clinical and Translational Sciences, St. Louis, MO. Electronic address: stepanj@wusm.wustl.edu.
authors.forename: Jeffrey G
authors.initials: JG
authors.lastname: Stepan
authors.affiliation: Department of Orthopaedic Surgery, Washington University School of Medicine in St. Louis, St. Louis, MO; Washington University School of Medicine in St. Louis, St. Louis, MO; Washington University in St. Louis Institute of Clinical and Translational Sciences, St. Louis, MO.
authors.forename: Daniel A
authors.initials: DA
authors.lastname: London
authors.affiliation: Department of Orthopaedic Surgery, Washington University School of Medicine in St. Louis, St. Louis, MO; Washington University School of Medicine in St. Louis, St. Louis, MO; Washington University in St. Louis Institute of Clinical and Translational Sciences, St. Louis, MO.
authors.forename: Martin I
authors.initials: MI
authors.lastname: Boyer
authors.affiliation: Department of Orthopaedic Surgery, Washington University School of Medicine in St. Louis, St. Louis, MO; Washington University School of Medicine in St. Louis, St. Louis, MO; Washington University in St. Louis Institute of Clinical and Translational Sciences, St. Louis, MO.
authors.forename: Ryan P
authors.initials: RP
authors.lastname: Calfee
mesh_terms: D001786:Blood Glucose / Q000032:analysis / Q000187:drug effects*; D002349:Carpal Tunnel Syndrome / Q000188:drug therapy / Q000453:epidemiology; D053684:De Quervain Disease / Q000188:drug therapy / Q000453:epidemiology; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000188:drug therapy / Q000453:epidemiology; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects*; D006442:Glycated Hemoglobin; D006225:Hand; D006801:Humans; D008775:Methylprednisolone / Q000008:administration & dosage / Q000009:adverse effects*; D010003:Osteoarthritis / Q000188:drug therapy / Q000453:epidemiology; D011446:Prospective Studies; D012307:Risk Factors; D052582:Trigger Finger Disorder / Q000188:drug therapy / Q000453:epidemiology; D014953:Wrist
chemical_list: D001786:Blood Glucose; D005938:Glucocorticoids; D006442:Glycated Hemoglobin; D008775:Methylprednisolone
keywords: Blood glucose; corticosteroid; diabetes; methylprednisolone