Glucocorticoid epidural for sciatica: Metabolic and endocrine sequelae

Authors: Ward, A., Watson, J., Wood, P., Dunne, C. and Kerr, D.

Journal: Rheumatology

Volume: 41

Issue: 1

Pages: 68-71

ISSN: 1462-0324

DOI: 10.1093/rheumatology/41.1.68

Abstract:

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 (kITT) 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.

Source: Scopus

Glucocorticoid epidural for sciatica: metabolic and endocrine sequelae.

Authors: Ward, A., Watson, J., Wood, P., Dunne, C. and Kerr, D.

Journal: Rheumatology (Oxford)

Volume: 41

Issue: 1

Pages: 68-71

ISSN: 1462-0324

DOI: 10.1093/rheumatology/41.1.68

Abstract:

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.

Source: PubMed

Glucocorticoid epidural for sciatica: metabolic and endocrine sequelae

Authors: Ward, A., Watson, J., Wood, P., Dunne, C. and Kerr, D.

Journal: RHEUMATOLOGY

Volume: 41

Issue: 1

Pages: 68-71

ISSN: 1462-0324

DOI: 10.1093/rheumatology/41.1.68

Source: Web of Science (Lite)

Glucocorticoid epidural for sciatica: metabolic and endocrine sequelae

Authors: Ward, A., Watson, J.M., Wood, P., Dunne, C. and Kerr, D.

Journal: Rheumatology

Volume: 41

Pages: 68-71

ISSN: 1462-0324

Abstract:

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 (kITT) 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.

KEY WORDS: Glucocorticoid, Insulin sensitivity, Epidural, Adrenal suppression, Sciatica.

Source: Manual

Preferred by: David Kerr

Glucocorticoid epidural for sciatica: metabolic and endocrine sequelae.

Authors: Ward, A., Watson, J., Wood, P., Dunne, C. and Kerr, D.

Journal: Rheumatology (Oxford, England)

Volume: 41

Issue: 1

Pages: 68-71

eISSN: 1462-0332

ISSN: 1462-0324

DOI: 10.1093/rheumatology/41.1.68

Abstract:

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.

Source: Europe PubMed Central