PM&R
Volume 1, Issue 4 , Pages 340-345 , April 2009

The Effects of Epidural Betamethasone on Blood Glucose in Patients with Diabetes Mellitus

  • Peter Gonzalez, MD

      Affiliations

    • University of Colorado Denver, School of Medicine, Department of Physical Medicine and Rehabilitation, PO Box 6511, Mail Stop F-493, Aurora, CO 80045†
    • Corresponding Author InformationAddress correspondence to: P.G.
    • ,
  • Scott R. Laker, MD

      Affiliations

    • University of Washington, School of Medicine, Department of Rehabilitation Medicine, Seattle, WA‡
    • ,
  • William Sullivan, MD

      Affiliations

    • University of Colorado Denver, School of Medicine, Department of Physical Medicine and Rehabilitation, Aurora, CO§
    • ,
  • Jeri E.F. Harwood, PhD

      Affiliations

    • University of Colorado Denver, School of Medicine, Department of Pediatrics, Aurora, CO
    • ,
  • Venu Akuthota, MD

      Affiliations

    • University of Colorado Denver, School of Medicine, Department of Physical Medicine and Rehabilitation, Aurora, CO∥

Received 20 February 2008 ,Accepted 17 December 2008.

References 

  1. Riew KD, Yin Y, Gilula L, Bridwell KH, et al. The effect of nerve-root injections on the need for operative treatment of lumbar radicular pain (A prospective, randomized, controlled, double-blind study). J Bone Joint Surg Am. 2000;82A:1589–1593
  2. Weinstein SM, Herring SA. Lumbar epidural steroid injections. Spine J. 2003;3(215 Suppl):37S–44S
  3. McLain RF, Kapural L, Mekhail NA. Epidural steroid therapy for back and leg pain: mechanisms of action and efficacy. Spine J. 2005;5:191–201
  4. Siddall PJ, Cousins MJ. Spinal pain mechanisms. Spine. 1997;22:98–104
  5. Flower RJ, Blackwell GJ. Anti-inflammatory steroids induce biosynthesis of a phospholipase A2 inhibitor which prevents prostaglandin generation. Nature. 1979;278:456–459
  6. Botwin KP, Gruber RD, Bouchlas CG, Torres-Ramos FM, Freeman TL, Slaten WK. Complications of fluoroscopically guided transforaminal lumbar epidural injections. Arch Phys Med Rehabil. 2000;81:1045–1050
  7. Katzung BG. Basic & Clinical Pharmacology. 8th ed.. New York: Lange Medical Books/McGraw-Hill; 2001;
  8. Ward A, Watson J, Wood P, Dunne C, Kerr D. Glucocorticoid epidural for sciatica: metabolic and endocrine sequelae. Rheumatology (Oxford). 2002;41:68–71
  9. Maillefert JF, Aho S, Huguenin MC, et al. Systemic effects of epidural dexamethasone injections. Rev Rhum Engl Ed. 1995;62:429–432
  10. Stambough JL, Booth RE, Rothman RH. Transient hypercorticism after epidural steroid injection (A case report). J Bone Joint Surg Am. 1984;66:1115–1116
  11. Kay J, Findling JW, Raff H. Epidural triamcinolone suppresses the pituitary adrenal axis in human subjects. Anesth Analg. 1994;79:501–505
  12. Younes M, Neffati F, Touzi M, et al. Systemic effects of epidural and intra-articular glucocorticoid injections in diabetic and nondiabetic patients. Joint Bone Spine. 2007;74:472–476
  13. Wang AA, Hutchinson DT. The effect of corticosteroid injection for trigger finger on blood glucose level in diabetic patients. J Hand Surg [Am]. 2006;31:979–981
  14. Feldman-Billard S, Du Pasquier-Fediaevsky L, Heron E. Hyperglycemia after repeated periocular dexamethasone injections in patients with diabetes. Ophthalmology. 2006;113:1720–1723
  15. Habib GS, Abu-Ahmad R. Lack of effect of corticosteroid injection at the shoulder joint on blood glucose levels in diabetic patients. Clin Rheumatol. 2007;26:566–568
  16. Linn A, Stoller A, Simopoulos T, Peeters-Asdourian C. Changes in blood glucose levels in diabetics after epidural steroid injection. Abstract presented at: 24th Annual Meeting of the American Academy of Pain Medicine; February 2008; Orlando, FL.

 Disclosure Key can be found on the Table of Contents and at www.pmrjournal.org

PII: S1934-1482(08)00082-8

doi: 10.1016/j.pmrj.2008.12.007

PM&R
Volume 1, Issue 4 , Pages 340-345 , April 2009

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