Dealing with a massive blood sugar spike from cortisone shot?

Hi Brenda, dealing with a sudden, massive increase in your numbers after a joint injection can be incredibly stressful, especially when your standard correction doses barely seem to make a dent.

The culprit here is the medication itself. Corticosteroids are powerful anti-inflammatory drugs, but they are also notorious for wreaking absolute havoc on glucose management. When cortisone enters your system, it triggers your liver to dump extra stored glucose into your bloodstream, while simultaneously and drastically increasing your body's cellular insulin resistance. In short, your body is suddenly dealing with more sugar while blocking the very hormone needed to process it.

Even for a localized injection—like a cortisone shot in a shoulder, knee, or hip—some of the medication inevitably makes its way into your general bloodstream. Typically, the blood sugar spike from cortisone shot begins within just a few hours of leaving the doctor's office and is most severe for the first 24 to 48 hours. For most people, this extreme insulin resistance will slowly taper off over the course of three to seven days as the medication settles into the joint.

During this frustrating week, many people find they need to proactively increase their basal (background) insulin or utilize much heavier correction ratios just to keep their numbers somewhat in range. Staying highly hydrated by drinking extra water can also help your kidneys flush out some of the excess glucose. Because steroids make you so stubbornly resistant, the best approach is to test frequently, try not to panic over the temporary highs, and follow any sick-day medication protocols you have established with your healthcare team to get you safely through the week.