Impact of Intra-Articular Corticosteroid Injection on Glycemic Control: A Population-Based Cohort Study

Author:

Sytsma Terin T.1ORCID,Greenlund Laura S.1,Fischer Karen M.2,McCoy Rozalina G.13ORCID

Affiliation:

1. 1Mayo Clinic Division of Community Internal Medicine, Geriatrics, and Palliative Care, Department of Medicine, Rochester, MN

2. 2Mayo Clinic Division of Clinical Statistics, Rochester, MN

3. 3Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Rochester, MN

Abstract

This retrospective cohort study investigated the longer-term hyperglycemic effects of intra-articular corticosteroid (IACS) administration by evaluating changes in A1C after large joint IACS injection. Among 1,169 patients (mean age 66.1 ± 12.2 years, 52.8% female), 184 (15.7%) experienced a greater-than-expected rise in A1C (actual A1C ≥0.5% above predicted) after IACS. Greater-than-expected rise in A1C was associated solely with baseline A1C (odds ratio [OR] 1.84, 95% CI 1.08–3.13 for baseline A1C of 7.0–8.0% compared with <7.0% and OR 4.79, 95% CI 2.83–8.14 for baseline A1C >8.0% compared with <7.0%). Although most patients do not experience an increase in A1C after IACS, clinicians should counsel patients with suboptimally controlled diabetes about risks of further hyperglycemia after IACS administration.

Funder

Mayo Clinic

National Institute of Diabetes and Digestive and Kidney Diseases

National Center for Advancing Translational Sciences

Publisher

American Diabetes Association

Subject

Endocrinology, Diabetes and Metabolism,Internal Medicine

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