Impact of Intra-Articular Corticosteroid Injection on Glycemic Control: A Population-Based Cohort Study
Terin T Sytsma1, Laura S Greenlund1, Karen M Fischer2
1Mayo Clinic Division of Community Internal Medicine, Geriatrics, and Palliative Care, Department of Medicine, Rochester, MN.
Summary
Intra-articular corticosteroid injections can increase A1C levels in patients with diabetes. Those with higher baseline A1C are most at risk for hyperglycemia after these joint injections.
Area of Science:
- Endocrinology
- Rheumatology
- Pharmacology
Background:
- Intra-articular corticosteroid (IACS) injections are commonly used for joint inflammation.
- The impact of IACS on glycemic control, particularly longer-term effects, requires further investigation.
Purpose of the Study:
- To evaluate the hyperglycemic effects of large joint IACS administration by analyzing changes in A1C.
- To identify patient factors associated with significant A1C elevation post-IACS.
Main Methods:
- Retrospective cohort study design.
- Inclusion of 1,169 patients receiving large joint IACS injections.
- Analysis of A1C changes and association with baseline A1C levels.
Main Results:
- 15.7% of patients (184/1,169) experienced a greater-than-expected rise in A1C (≥0.5% above predicted).
- Elevated baseline A1C was the sole predictor of increased A1C post-IACS.
- Patients with baseline A1C 7.0-8.0% and >8.0% had significantly higher odds of A1C increase compared to those with A1C <7.0%.
Conclusions:
- While most patients do not experience significant A1C increases after IACS, a notable proportion do.
- Baseline glycemic control is a critical factor in predicting post-IACS hyperglycemia.
- Clinicians should counsel diabetic patients, especially those with suboptimal control, on the potential risks of hyperglycemia following IACS administration.
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