The effect of intra-articular injection of betamethasone acetate/betamethasone sodium phosphate on blood glucose levels in controlled diabetic patients with symptomatic osteoarthritis of the knee

To evaluate the effect of intra-articular steroid injection (IASI) of betamethasone acetate/betamethasone sodium phosphate (Celestone Chronodose) at the knee joint on blood glucose and fructosamine levels in controlled diabetic patients with osteoarthritis of the knee. Controlled diabetic patients (HgA1C < 7) with symptomatic osteoarthritis of the knee who failed medical and physical therapy and use modern versions of home-monitoring blood glucose devices were offered an IASI of Celestone Chronodose at the knee joint. If agreed, patients were asked to document blood glucose levels before and 2 h after meals for 1 week prior to IASI and daily for 4 days then every other day for 10 days following IASI of 1 ml of Celestone Chronodose. Serum fructosamine levels were obtained just prior and 2 weeks following the injection. Six patients completed the study and all had a significant brisk elevation of blood glucose levels within the first hour lasting for less than 48 h in five of them. Mean glucose level 1 h following the injection was 218.33 ± 41.75 mg% and mean maximal level 322.5 ± 67.75 mg%. There was no significant change in fructosamine levels. IASI of Celestone Chronodose will transiently increase blood glucose levels in diabetic patients. It has no significant effect on serum fructosamine levels.