Steroid Injection

I’m having knee issues. Pain, swelling etc. I’m doing PT but it’s not helping that much now- after an initial big improvement I took two steps back. A steroid injection is another possible treatment for this and I wonder how your Bg reacted if you had this done? Except for eye drops and nose sprays I haven’t used any steroids since my diagnosis so I’m not sure what to expect and if I should try it if I don’t improve. I’m having an mri soon to see if something else is going on other than patellar arthritis aggravated by trying to plant something.

I would expect that steroids would probably increase BG levels, but YOUR specific reaction is the only one that matters. You’re also the only one here able to measure and evaluate what’s happening.

There may be a big difference between taking a steroid all the time and having an injection every once in a while.

I remember having fluid on my knee for a while in the early eighties. The doctor always removed too much fluid and then injected the cortisone right in there.

Knowing specifically what’s functionally CAUSING the knee issue so you can heal is the best thing. But an inflamed knee makes it difficult to do that.

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Like @Timbeak48 says, YDMV, but my experience with orthopedic steroid injection was that it elevated my BG significantly and the effect lasted for 2-3 weeks. Biggest problem was the lack of warning–orthopedist had no idea it would have this effect–and it took a while before I figured out what was causing it. But if you know to expect it, you can at least be prepared.


My experience was same as drbb. No caution from ortho Dr prior to injection for frozen shoulder, and BGs were very high. Thought I had a bad bunch of BG strips.

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I had one knee steroid injection prior to surgery. I made the ortho doctor aware of my diabetes and called by Endo before receiving my injection. The day of my injection I was told to increase my basal rate by 20% for 24 hours and if I was elevated after 24 hours increase my basal rate by 4% and monitor blood sugars every hour and bolus if necessary and monitor ketones if I went above 230 at any period. Well; I am never to get another steroid. I elevated to 525 even with basal rates increased and bolus corrections. My Endo was made aware and continued to monitor how is was doing. The elevations lasted 27 hours. Just rememeber everyone is very different and just let your ortho doctor know your diabetic and make your Endo aware and receive their advice.


Yeah, I’ve had them several times, and each time, my blood sugars were elevated for the better part of a week, with the worst effects for the first few days. If you really need the injection, it may well be worth it despite the effects on blood sugars, but you might want to strategize re: raising basal rates/long-acting doses and/or correction strategies. I also found that even when I was high, I had to correct much more aggressively during that time, since it felt like I was injecting water at first. It can be easy to then overdo it though too in frustration.


Steroid injections elevated my bg’s for about ten days to two weeks. Had to run a 50% basal increase for several days. Gradually tapered that off.

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I have severe reactions, BG related, to steroids. I need a basal increase of 100% to cover the BG reaction for 24 hours. I avoid steroids. Not fun.

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Thanks to Drbb, I had a heads up. One day after injection, 300 plus al day, no amount of insulin seemed to help, up’d all Basel rates, helped a bit. I had taken week off from work so after 2 days of running that high, I basically stopped eating any carbs. Did this for about 4 more days and bg ran between 200-250 which felt like a win compared to the 300 plus days. Everything started feeling normal on day seven. BUT ydmv, but just no that it will make your insulin seem useless. On plus side I lost six pounds :smirk:


It is difficult to say exactly. I have had steroid injections in my back and had almost no impact. I have also had them in my hand and seen it skyrocket. So what will happen with yours? I have to say only you will be able to judge.

So what to do? Talk to your endocrinologist pre-injection. Doing that will help chart a course if it is good, bad or indifferent. I use Lantus to help me manage steroids when I use them if needed. I will generally keep the basal as normal on my pump and inject 1/2 daily basal with Lantus at the first sign of my Blood sugar going over 250.

I use this for all steroid use and as a guy with RA I have steroids much too often.


Had an injection of kenalog a couple years ago and since I’m on a Medtronic CGM I noticed I needed to raise my basal to 150 % and increase all my boluses by 30-40% for about 3 weeks. The sad thing was the kenalog steroid didn’t relieve the itchy stress hives. Now I know.

I will say my bg reaction to steroids made me appreciate how much easer it is wearing both a CGM and a pump.


Thanks Jane and everyone, I’m scared I will have really high Bg and end up in the hospital. So I will have to not do this. I have a hard enough time managing all of this as it is and I do not want blood sugar that is even more difficult to manage. My knee is not getting better and I’m not sure what to do at this point the therapy is not really helping I was not able to do an MRI today because even though it was open standup MRI I had to go much further into that narrow space and I knew I wasn’t gonna be able to do it so I’m going to ask my doctor to do a CAT scan instead. It is very odd because today was worse but the therapist was trying to say my range of motion was normal yet I was not able to go down the stairs when I got up. And then by the end of the day when I came home my knee was visibly more swollen just don’t know what is causing all of this I mean the injury supposedly was like over six weeks ago shouldn’t it be getting better by now? I did have an ultrasound to make sure this is not a blood clot but I’m wondering if they could’ve missed something on there?

I mean, if I were you, I’d probably talk to your endo and figure out a strategy so you could try the cortisone shot if that’s bad and what your team is recommending… I think what most of us are saying is that yes, it will mess with your blood sugars, but if it’s necessary, it’s something you can manage around, especially if you’re expecting it and plan for it.

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I took oral steroids for inflamed and bleeding sinuses.
I’m type 2 My bg increased significantly. 50 g or more in the morning Course was I believe one week. Levels also stayed elevated week to ten days after. I was quite concerned and wondered if they would not go down. My internist never mentioned this as a side effect. They did heal my sinus issue but I would think long and hard before taking again

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Thanks cardamom, but since there is no way to know if this will cause high bg so bad I need to go to an er there is no way I’m doing it. It’s not worth it unless I’m in some sort of emergency like I lose total mobility etc. I’m still able to get around- for the stairs I just use my other leg to do the work and I’m going to limit my activity as much as possible until I see improvement. This often works for me. It did with my back- I started out with a severe back spasm and now my whole summer has been wasted on this crap with pt etc.

I had bursitis in one of my shoulders and had a steroid injection not long before my d diagnosis and it had a dramatic effect. But at that point I couldn’t even lift my arm, directly after the shot I was able to but still had a lot of pain and needed 4 months therapy. I wonder if that was one of the things that finally pushed me into dka a year or so later.

I’m able to get around now so I will just have to take aleve as needed and hope it resolves eventually. I took some last night and it helped but not as much as usual as my knee was still more inflexible when I got up but it’s improving now as the day goes on. I’m still trying to get a cat scan arranged hopefully tomorrow.

HI Margie, well at least they helped you. I agree, we need to be very careful with steroids… and it’s not just the high bg but after when the effect wears off and we crash. I think for sinus I would not do anything unless it was really severe. I have used a foam for poison ivy last year and I think that did raise me but it was not as long as a pill or a shot and I only used it a few x due to the high bg.

A CT scan will not show any defined tendon, ligament, ACL, or meniscus injuries of the knee or defined disc problems of the back. If anything is seen questionable on CT they will order an MRI for defined treatment. In the Emerency Room will deal with these injuries all the time and treating those problems with CT only would be a dis-sevice to you. If you can’t stand the closeness of the MRI they can medicate you. We do sedated MRI very frequently and patients do very well. I had 4th degree tears of my medial and lateral meniscus which had to be surgical corrected. These injuries did not show up on CT but we’re very visible on MRI.


Hi, meee! What a pickle you’re in–steroids might really help the knee pain, but high sugars might cause more problems. Others have shared their experiences and thoughts–next step, I would think, is to talk to whoever helps manage your diabetes. Folks on insulin have shared. I’m on insulin now, but wasn’t when I had a severe allergic reaction to antibiotics–intravenous steroids, then pills for a week! Did lots of testing, cut out carbs as much as I could and talked with my doctor regularly that week. Since then, I’ve had injections in my hands and foot without significant BS problems, but I was prepared–test, test, test and talk to the doc.

Don’t pass up an opportunity for relief. As Buffy the Vampire Slayer said, “Fate favors the prepared!”

Thanks David – I went back to that open MRI and medicated myself yesterday and I was able to do it- the whole top was open and it was easier than the usual there. I have looked at my MRI but I can’t tell if anything is wrong. Anyway I will have to wait and see. My therapist said even if there is a tear it’s not going to change the therapy and they won’t necessarily do surgery. I feel a bit better the past two days - knock on wood- hopfully it’s starting to heal.

Did you have a lot of pain with your injury and how did it happen?

Thanks Ms. Mody – as I said I’m not going to use a steroid unless I’m in some sort of emergency situation and I can’t move at all like with my frozen shoulder.