Objective
To investigate the change of blood glucose and cortisol levels after three consecutive epidural steroid injections Method: Fifteen patients with low back pain and radiating pain were included. Three consecutive epidural injections were performed weekly. The serum glucose, insulin and cortisol levels were measured 30 minutes before the 1st injection and at 24 hours and l week after each injection. Results: There were significant changes in the result of glucose and insulin levels at 24 hours after each injection (p＜0.05), but no signigicant changes at 1 week compared with pre-injection level. The cortisol level significantly decreased at 24 hours after 1st injection and did not return to pre-injection level at 1 week after 1st injection (p＜0.05). There were no further increases in the glucose and insulin levels and no further decrease in the cortisol level after each of the three consecutive injections. Conclusion: Three consecutive epidural injections at 1 week interval seems to be as safe procedure. But significant suppression of cortisol kept on for 1 week, so it should be taken into account when patients with previous epidural injection undergo major stress. (J Korean Acad Rehab Med 2006; 30: 590-594)

OBJECTIVE
This study was designed to investigate the effect of steroid injection on the blood sugar level in shoulder pain patients with diabetes mellitus. METHOD: Fifteen patients with shoulder pain and diagnosed diabetes mellitus were included. The blood sugar, insulin, cortisol and HbA1c level were measured before and twice (at 24 hours and 1 week) following a intraarticular, intratendinous or intrabursal injection containing triamcinolone. Statistical significance was determined by the paired t-test. RESULTS: The blood sugar, insulin and HbA1c levels had no significant difference between before and after steoid injection (p>0.05). But, the cortisol level significantly fell at 24 hours after steroid injection compared with preinjection level and returned to preinjection level by 1 week after steroid injection (p<0.05). CONCLUSION: One time triamcinolone injection resulted in significant suppression of cortisol level, but it returned to preinjection level after a week. The blood level of sugar, insulin and HbA1c showed no significant change after one time steroid injection.