Powered By
Continue with Facebook
Continue with your email
When you get a cortisone shot or steroid injection for joint and muscle pain, you may see your blood sugar rise unexpectedly. “I just had two cortisone shots in both my shoulders, and when I woke up this morning, my blood sugars were higher than normal for me,” one DiabetesTeam member said.
Steroid shots can cause short-term increases in blood sugar, especially in people with diabetes. Understanding why this happens, how long it may last, and what you can do to stay safe can help you feel more in control.
Steroid shots reduce pain and swelling by calming inflammation. These injections contain a steroid — such as cortisone, methylprednisolone, or triamcinolone — that temporarily decreases your body’s immune system activity. They do this by acting like cortisol, a hormone that’s naturally produced by your body. Decreasing the immune system response, in turn, reduces inflammation.
To relieve pain, steroid shots are directly given into a joint like the spine, shoulder, hand, hip, or knee. However, some of the medication still enters into the bloodstream. Once there, steroids affect how your body manages glucose, or sugar.
Steroids raise blood sugar levels, or blood glucose levels, in three main ways:
Most people with type 2 diabetes already have insulin resistance. The extra push from the steroid shot can cause blood sugar levels to rise sharply.
Changes in blood sugar vary from person to person. But research shows that for some people with diabetes, increases can be significant.
One study found that in people with well-controlled type 2 diabetes, blood sugar levels after a steroid injection ranged from 165 mg/dL to 500 mg/dL. The highest blood glucose levels usually happened between two hours and 3.5 days after the steroid injection. They didn’t return to baseline blood sugar levels until up to 21 days later.
“My blood sugar rose from 110 to 180 in less than a week due to a cortisone shot in my hip,” wrote one DiabetesTeam member. “I have had a couple of cortisone shots,” added another. “My blood sugar went up by about 10 mg/dL for a few days after each shot.”
In addition, people who had higher A1C levels before receiving the injection also saw bigger and longer-lasting blood sugar spikes than those with tighter glucose control. This rise in blood glucose was often seen one day after injection, but not two days after.
Since steroid shots may increase blood sugar up to 500 mg/dL, it’s important to be aware of other possible severe complications. This includes diabetic ketoacidosis, where the body starts breaking down fat instead of sugar to obtain fuel, due to a lack of insulin. While this is not often reported as a complication of steroid injections, it’s important to recognize the symptoms. For instance, you may experience frequent urination, vomiting, nausea, stomach pain, shortness of breath, and breath that’s fruity-smelling. If you notice any of these symptoms, let your doctor know as soon as possible.
Steroid shots are considered safe for most people with type 2 diabetes when used carefully. Medical researchers agree that diabetes alone isn’t a reason to avoid steroid injections.
However, safety could depend on a few factors:
Studies show that people with poorly controlled diabetes are more likely to have higher blood sugar levels after a steroid shot. Doctors recommend discussing recent A1c values and typical glucose patterns with your provider before the injection.
For many people, the benefits of pain relief and reduced inflammation outweigh the short-term rise in blood sugar, especially when there is a plan in place to manage it.
Keep in mind that some medications may not react well to steroid injections. Make sure you discuss all the medications you’re currently taking with your doctor. For example, if you have an infection or are taking antibiotics to treat an infection, a steroid shot may make it hard for your body to heal properly. Those taking blood-thinners may also not be able to receive steroid shots safely.
Some research suggests that the area where the steroid is injected can affect blood sugar response. One study followed people with diabetes after steroid injections. The researchers found that shoulder, wrist, and hand injections caused smaller or shorter blood sugar increases than those given in other areas. Knee injections were more likely to lead to noticeable blood sugar elevations.
Steroid-related blood sugar changes are usually temporary. A large review found that blood sugar levels often peak between two and 84 hours after the injection. Most people see their levels return close to normal within three to seven days, though some take up to two or three weeks. This is mainly caused by having a higher A1c before the steroid injection.
For most people, these changes don’t permanently worsen diabetes control. Blood sugar levels typically return to normal shortly after an injection.
“I had to go get a steroid shot in my neck today, so sugar is kinda out of control,” wrote a DiabetesTeam member. “They said the next two days could be rough until the shot gets settled in.”
“My blood sugar has been a little high today because of the steroid shot to my foot yesterday. It should be settling down by tomorrow though,” shared another member.
A steroid shot doesn’t have to throw your blood sugar off track for long. By taking a few steps, you can reduce the impact and get back to your baseline more quickly. Here are a few ways you can stay in control after your injection.
Doctors recommend checking blood sugar more frequently for about three days after a steroid injection or until blood sugar levels are back to their baseline numbers. You should also be aware of side effects of high blood sugar, or hyperglycemia. These include more frequent urination, tiredness, blurred vision, and feeling thirsty more often.
Some people may need to adjust their medication temporarily, especially those who use insulin. Providers sometimes recommend short-term increases in dosage when the effects of the steroid are at their peak.
Remember, don’t make any adjustments to your insulin or other medications without talking to your healthcare team, and be sure to follow their instructions.
During this time, be sure to stick to your current diabetes eating plan, which usually means limiting sugary foods. You may also need to choose low glycemic foods that are slowly digested, such as whole-grain cereals, breads, pasta, and rice.
Contact your healthcare provider or emergency services right away if you have high blood sugar alongside symptoms such as:
Steroid shots can temporarily raise blood sugar in people with type 2 diabetes. Blood glucose increases are most noticeable in the first few days, but you can manage them with proper planning, monitoring, and diabetes management. Be sure to note when you received your steroid shot in your blood sugar log, and discuss any rise in blood sugars with your healthcare team at your next appointment.
Through open communication with your healthcare team, extra blood sugar checks, and making short-term adjustments when needed, you can receive steroid injections safely and get the pain relief you need.
On DiabetesTeam, people share their experiences with diabetes, get advice, and find support from others who understand.
How have you managed your blood sugar levels after a steroid shot? Let others know in the comments below.
Get updates directly to your inbox.
Continue with Facebook
Continue with your email
Become a member to get even more
Join
This is a member-feature!
Sign up for free to view article comments.
We'd love to hear from you! Please share your name and email to post and read comments.
You'll also get the latest articles directly to your inbox.