Cortisone injections treat many joint and tendon conditions, but people with diabetes are more prone to side effects and need to take extra care. So, with cortisone injection and diabetes, what should you know to make the right decision?
Why is diabetes a concern with cortisone?
Diabetes reduces your ability to process glucose, so blood sugar levels run high. That matters here for two reasons. First, high blood sugar makes several musculoskeletal conditions more common and harder to treat — frozen shoulder, trigger finger, Achilles tendonitis, knee and hip osteoarthritis, and carpal tunnel syndrome. Second, cortisone itself raises blood sugar, and in diabetes, those levels go higher and stay up longer.
What the evidence shows about cortisone and blood sugar in diabetes
Several studies map out how cortisone affects blood sugar after an injection:
- In type 2 diabetics, after a shoulder injection, sugar levels stayed elevated for about three days, then normalised from day four. Only about 10% had high levels, and none needed extra medication.
- In another shoulder-injection study, well-controlled diabetics had raised sugar until about day 8, but poorly controlled or insulin-dependent patients had much higher levels lasting more than ten days.
- After hand injections, sugar rose for 1–2 days, higher and longer in insulin-dependent diabetics.
The type and dose of cortisone also matter. In people with diabetes, we take a more conservative approach — a slightly lower dose of a less potent cortisone (such as Depo-Medrol rather than the more potent triamcinolone). People with diabetes also have somewhat lower immune function, which adds a small extra infection risk after an injection.
How to manage blood sugar around a cortisone injection
If you have diabetes and are considering a cortisone shot, take a few precautions to keep it safe.
Tell your doctor about your diabetes — including recent sugar readings, your HbA1c, and your medication or insulin doses. Then:
- Consider postponing the injection if your blood sugar levels are unstable or your HbA1c is above 7%.
- Monitor closely — several times a day for five days after the shot, or for ten days if you have unstable diabetes or use insulin.
- Start monitoring about 6 hours after the injection.
- Adjust medication if your sugars climb — more insulin or oral medication as advised. If they stay very high despite that, contact your GP or go to your nearest emergency department.
Frequently asked questions about cortisone injections and diabetes
How high will my blood sugar go after a cortisone injection?
It varies. Well-controlled diabetics often see a modest rise settling within a few days; poorly controlled or insulin-dependent diabetics can see higher levels lasting up to ten days or more. Close monitoring tells you what’s happening for you.
How can I lower my blood sugar after a cortisone shot?
Eat carefully and stay active (after checking on post-injection activity with your doctor), and increase your oral medication or insulin as advised to counteract the temporary rise. The effect is transient.
Can I still have a cortisone injection if I’m diabetic?
Usually, yes — diabetes isn’t an absolute barrier. It means taking precautions: a lower dose of a less potent cortisone, close monitoring of blood sugar, and postponing if your control is currently poor (HbA1c above 7%).
Do people with diabetes respond as well to cortisone?
Often a bit more slowly. With conditions such as frozen shoulder and Achilles tendonitis, pain and function tend to take longer to improve in diabetes — but that doesn’t mean you have to live with the problem.
Is the blood-sugar rise permanent?
No — it’s temporary. Levels usually return to normal within a few days to about ten days, depending on your sugar control and whether you use insulin.
Final word from Sport Doctor London about cortisone injection and diabetes
Always tell your doctor if you have diabetes before a cortisone shot. Blood sugar can stay elevated for up to about ten days, depending on your control and whether you’re on insulin — so monitor closely and adjust your medication as advised. With sensible precautions, a cortisone injection can still be a safe, useful option.
To discuss a cortisone injection with Dr Masci in London, contact the team here or call +44 (0) 203 488 0350.
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