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Glucocorticoid epidural for sciatica: metabolic and endocrine sequelae

OBJECTIVE: The study was designed to investigate the effect of epidural administration of glucocorticoid on insulin sensitivity. METHODS: Ten healthy individuals with sciatica underwent a short insulin tolerance test before and twice following (at 24 h and 1 week) a caudal epidural containing 80 mg triamcinolone. Fasting glucose, insulin and cortisol concentrations were also measured. RESULTS: The rate of glucose disappearance after insulin administration (k(ITT)) fell from 3.6%/min before the epidural to 1.9%/min 24 h afterwards (P=0.001) and returned to pretreatment values by 1 week. Significantly raised fasting insulin and glucose levels also reflected impaired insulin sensitivity immediately after the epidural. Morning cortisol levels were suppressed after the epidural (49 nmol/l at 24 h and 95 nmol/l at 1 week vs 352 nmol/l at baseline; P<0.01). CONCLUSIONS: Epidural administration of glucocorticoid results in potent suppression of insulin action and this should be taken into account when patients with diabetes require treatment for sciatica Keywords : administration & dosage,Adult,analysis,blood,Blood Glucose,diagnosis,drug therapy,Female,Follow-Up Studies,Glucocorticoids,Glucose,Glucose Tolerance Test,Humans,Hydrocortisone,Injections,Epidural,Insulin,Male,metabolism,methods,Middle Aged,Pain Measurement,Patients,Pilot Projects,Probability,Sciatica,Sensitivity and Specificity,Treatment Outcome,Triamcinolone,, Epidural,Sciatica,Metabolic, sciatica specialist

Date of Publication : 2002 Jan

Authors : Ward A;Watson J;Wood P;Dunne C;Kerr D;

Organisation : Bournemouth Diabetes and Endocrine Centre, Royal Bournemouth Hospital, Castle Lane East, Bournemouth BH7 7DW, UK

Journal of Publication : Rheumatology (Oxford)

Pubmed Link : https://www.ncbi.nlm.nih.gov/pubmed/11792882

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