Angela A Wang1, Douglas T Hutchinson. 1. Department of Orthopaedic Surgery, University of Utah, Salt Lake City, UT 84108, USA. angela.wang@hsc.utah.edu
Abstract
PURPOSE: To determine how corticosteroid injections for trigger finger affect the blood glucose level in diabetic patients and the clinical results of those injections. METHODS: Eighteen diabetic patients receiving a methylprednisolone injection for a single trigger finger were studied. Six patients had type I (juvenile-onset) diabetes and 12 patients had type II (adult-onset) diabetes. Patients recorded their usual blood glucose measurements and then they recorded their blood glucose measurements for 5 days after injection. Clinical efficacy of the injections was measured by avoidance of surgery. RESULTS: There were 3 men and 15 women with an average age of 58 years. The blood glucose level increased after corticosteroid injection for all patients. The first morning after injection showed the biggest increase in blood glucose level: 73% more than the average preinjection levels. By the fifth morning after injection the blood glucose levels still were increased by 26% more than the preinjection levels. This trend was marked particularly in type I diabetic patients, who had an average blood glucose level increase the first morning after injection of 145%, which decreased over 5 days to 22% greater than baseline levels. Sixteen patients had follow-up evaluation over a period of 1 year and of these 16 patients 7 required surgery for this condition. CONCLUSIONS: A digital injection of the corticosteroid methylprednisolone acetate in diabetic patients with trigger finger causes a hyperglycemic effect that lasts for at least 5 days but can help prevent the need for surgery more than half the time. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic, Level IV.
PURPOSE: To determine how corticosteroid injections for trigger finger affect the blood glucose level in diabeticpatients and the clinical results of those injections. METHODS: Eighteen diabeticpatients receiving a methylprednisolone injection for a single trigger finger were studied. Six patients had type I (juvenile-onset) diabetes and 12 patients had type II (adult-onset) diabetes. Patients recorded their usual blood glucose measurements and then they recorded their blood glucose measurements for 5 days after injection. Clinical efficacy of the injections was measured by avoidance of surgery. RESULTS: There were 3 men and 15 women with an average age of 58 years. The blood glucose level increased after corticosteroid injection for all patients. The first morning after injection showed the biggest increase in blood glucose level: 73% more than the average preinjection levels. By the fifth morning after injection the blood glucose levels still were increased by 26% more than the preinjection levels. This trend was marked particularly in type I diabeticpatients, who had an average blood glucose level increase the first morning after injection of 145%, which decreased over 5 days to 22% greater than baseline levels. Sixteen patients had follow-up evaluation over a period of 1 year and of these 16 patients 7 required surgery for this condition. CONCLUSIONS: A digital injection of the corticosteroid methylprednisolone acetate in diabeticpatients with trigger finger causes a hyperglycemic effect that lasts for at least 5 days but can help prevent the need for surgery more than half the time. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic, Level IV.
Authors: Anuntapon Chutatape; Mahesh Menon; Stephanie Man Chung Fook-Chong; Jane Mary George Journal: Singapore Med J Date: 2018-11-07 Impact factor: 1.858