Author(s)
Margaret C. Nurimba, MD
Yael Bensoussan, MD MSc
Karla O'Dell, MD
Affiliation(s)
Tina and Rick Caruso Dept. of Otolaryngology- Head and Neck Surgery, University of Southern California;
Abstract:
Introduction: Serial in-office awake steroid injections (SSIs) have gained popularity in laryngology for treatment of subglottic stenosis. They can be used as an adjunct to dilation under general anesthesia or as a primary treatment. Hyperglycemia has been observed in intraarticular corticosteroid injections specifically in diabetic patients. However, the effect of in-office intralesional subglottic steroid injections on blood glucose levels has not been previously reported.
Methods: Case report of a 61-year-old woman with insulin-dependent type II diabetes mellitus who underwent an in-office intra-lesional steroid injection (SSI) as part of our usual SSI protocol for subglottic stenosis. The patient glucometer readings pre and post injection, recorded per her usual routine, were obtained for review.
Results: The patient’s glucometer reading recorded severe hyperglycemia with a peak plasma glucose of 590 mg/dL five hours after SSI and above 300mg/dL for 24h after the procedure. The patient had increased insulin requirements for 3 days post injection with return to baseline plasma glucose levels on post-procedure day 4. No acute complications from her hyperglycemia were noted.
Conclusions: While intralesional corticosteroids are generally thought to have minimal systemic effects, further understanding of how these injections impact glucose control in diabetic patients is crucial for counseling and monitoring patients receiving these treatments in the future.