ABSTRACT

Background:

Epidural steroid injection is one of the safest and most effective ways to treat acute and chronic lumbar back pain syndromes. The aim of this study is to determine the early effects of single lumbar epidural injection on the fasting blood glucose.

Patients and Methods:

In this study, thirty-nine patients with chronic back pain and sciatica nerve pain who did not benefit from conventional therapies, such as anti-inflammatory medications and physiotherapy during last 6 months, were investigated. Each patient was given 80 mg triamcinolone acetonide via epidural route. Ten of the selected patients had type II diabetes mellitus and were treated with oral anti-diabetics. The fasting blood glucose were tested at baseline and at each post-treatment day during the first five days after the single epidural steroid injection.

Results:

The mean fasting blood glucose levels increased significantly between baseline (106.38± 26.10 mg/dl) and the first two post-treatment day (day 1, 125± 55.52 mg/dl with p= 0.002; day 2, 113.41± 35.19 mg/dl with p= 0.01) but returned to baseline values by the fourth treatment day (day 4, 106.67± 27.96 mg/dl with p= 0.9) in all patients. The mean fasting blood glucose level on the third post-treatment day was also higher than the baseline but the difference was not statistically significant. When patients with and without diabetes mellitus were evaluated as separate groups, the mean fasting blood glucose levels returned to baseline values on the third day of the treatment in non-diabetic patients, whereas on the fourth post-treatment day in diabetic patients.

Conclusion:

Epidural steroid injection may increase fasting blood glucose for a longer period in diabetic patients than those without diabetes mellitus. The patients should be informed about the influence of the epidural steroid injection on the blood glucose levels before the treatment procedure, but diabetic patients should also be offered regular blood glucose monitoring in the early period after the treatment.