From the Guidelines
Patients with type 1 diabetes should closely monitor their blood glucose levels after receiving steroid injections for carpal tunnel syndrome, as steroids typically cause significant blood sugar elevations that can last for several days to weeks. Check blood glucose more frequently (4-6 times daily) for at least 3-5 days after the injection, and be prepared to increase insulin doses temporarily. Most patients need to increase their basal insulin by 20-40% and may require additional correction doses. Some key points to consider:
- Watch for symptoms of hyperglycemia including increased thirst, frequent urination, fatigue, and blurred vision.
- Contact your healthcare provider if blood glucose consistently exceeds 250-300 mg/dL despite correction doses, or if you develop symptoms of diabetic ketoacidosis such as nausea, vomiting, abdominal pain, or fruity breath odor.
- Steroids cause insulin resistance by interfering with insulin signaling and increasing glucose production in the liver, making blood sugar management challenging even in well-controlled diabetes.
- Stay hydrated and maintain your usual meal plan while adjusting insulin according to your glucose readings or as directed by your healthcare provider, as recommended by the American Diabetes Association standards of medical care in diabetes 1. It is essential to follow the guidelines for self-monitoring blood glucose and continuous glucose monitoring to achieve optimal glycemic control, as outlined in the American Diabetes Association standards of medical care in diabetes 1.
From the Research
Monitoring Blood Glucose Levels
- A type 1 diabetes (T1D) patient who receives steroid injections for carpal tunnel syndrome should closely monitor their blood glucose levels, as steroid injections can cause a temporary increase in blood glucose levels 2, 3, 4.
- The increase in blood glucose levels can occur within 1-3 days after the injection and may last for several days 3, 4.
- Patients with T1D are more likely to experience a significant increase in blood glucose levels after steroid injections, especially if they are insulin-dependent 4.
Managing Hyperglycemia
- Patients should be aware of the signs and symptoms of hyperglycemia, such as increased thirst and urination, blurred vision, and fatigue 3.
- If patients experience any of these symptoms, they should seek medical attention immediately 3.
- Patients should also be advised to adjust their diabetes management plan, including their insulin dosage and diet, to account for the potential increase in blood glucose levels after steroid injections 4.
Steroid Injection Dosage
- A lower dose of steroid may be recommended to minimize the increase in blood glucose levels, while still providing effective pain relief 5.
- However, the optimal dosage of steroid for carpal tunnel syndrome in patients with T1D has not been established, and further research is needed to determine the best course of treatment 5.
Clinical Implications
- Healthcare providers should inform patients with T1D about the potential risks of steroid injections, including hyperglycemia, and provide guidance on how to manage their blood glucose levels after the injection 2, 3, 4.
- Patients should be closely monitored after steroid injections, and their diabetes management plan should be adjusted as needed to prevent complications 4.