Locally administered
corticosteroids are a common
therapy in many hand and wrist disorders.
Corticosteroids pose a theoretical risk to patients with
diabetes mellitus by potentially raising
blood glucose to hyperglycemic levels. Although oral
corticosteroids are known to have an effect on
blood glucose control, limited data exist on extra-articular administration. The purpose of this study was to examine the systemic impact of extra-articularly administered
corticosteroids in the hand and wrist on serum
glucose concentration in patients with
diabetes mellitus.Twenty-three patients with
diabetes mellitus received a 1-mL
triamcinolone acetonide injection for de Quervain's
tenosynovitis, trigger finger, flexor carpi ulnaris
tendonitis, or
carpal tunnel syndrome. Patients recorded their daily morning
blood glucose levels for 1 week before injection and for 4 weeks after injection. Average
blood glucose levels increased slightly from baseline after injection, reaching statistical significance 1, 5, and 6 days after injection, but were not clinically significant (average increase, 14.2, 9.7, and 32.7 mg/dL, respectively). Isolated increases more than 2 times the standard deviation of preinjection values occurred at least once in the majority of patients. The frequency of hyperglycemic episodes increased after injection, but the proportions of patients with at least 1 hyperglycemic episode before and after injection were not significantly different.These results suggest that local
corticosteroid injections are a clinically safe treatment option for inflammatory processes of the hand and wrist in patients with
diabetes mellitus. On average, patients experienced slight increases in
blood glucose after receiving an injection. Most experienced isolated increases substantially beyond baseline and isolated hyperglycemic effects, but these did not pose an apparent clinical risk.