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

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 to <7.0% and OR 4.79 (95% CI 2.83–8.14) for baseline A1C >8.0% compared to <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.

Key Points

· The longer-term impact of intra-articular corticosteroid (IACS) on diabetes is unknown.

· A1C did not rise more than expected after large joint IACS for most patients.

· An A1C >8.0% before IACS predicted a greater-than-expected rise in A1C after IACS.