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

This article contains supplementary material online at https://doi.org/10.2337/figshare.23925588.

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©2023 by the American Diabetes Association
2023
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