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Administered Kenalog injections for knee joint pain. Was taking metformin regimen. Want to avoid insulin. What to do?

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General & Family Physician
Practicing since : 2001
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Thanks, Dr. Grief. I would like to know simply if the KENALOG-40 Injections I have been administered for relief of knee joint pain (seems to be working nicely) would be at least partially responsible for a really bad spike in my blood sugar in this morning's test (reading of 396). I did indulge in a pomegranate/blueberry/limeade drink last night, which, of course, may also be a factor. Before the injections, I was on a metformin/prednisone regimen, but wanted to try to use exercise for the blood sugar control and avoid the drugs. Certainly, I want to avoid insulin.
Posted Wed, 31 Jul 2013 in Medicines and Side Effects
Answered by Dr. Michelle Gibson James 1 hour later
Hi, thanks for using healthcare magic

It is possible that the steroid injection is at least partially responsible for your increase in blood sugar but it should not cause it to go as high as 396.
The drink last pm may have also had an impact but still they may be an underlying problem with elevated blood sugars.

It is admirable that you are trying lifestyle regimens to maintain your blood sugar. Lifestyle is important aspect of management of diabetes.

Diabetes may progress due to burn out of the pancreas. In non diabetics or persons whose bloods are not pushed up due to medication (such as steroids) , there is enough insulin released to lower the blood sugar to normal so the pancreas is not worked to hard.

If the blood sugars high then the pancreas has to work hard to release enough insulin to push down to blood sugar.
If the pancreas is worked too hard then it burns out faster, this is the reason that the condition progresses from just oral medication to one tablet to more.

There was a medical study that looked at lifestyle changes and metformin to see if these can prevent the progression from prediabetes to full blown diabetes. Intense lifestyle changes reduced the chance of full diabetes by 58% . TO reduce the blood sugars the persons had to exercise 150 mins a week, reduce calorie intake and fat intake. They aimed to lose 7% of weight.

Metformin prevented full blown diabetes by 31%.

If with lifestyle you find it difficult to reduce the blood sugar especially with the injections , it may be best to use the metformin, this would reduce the burnout of the pancreas because then it would not have to work as hard to keep the blood sugar down.

I hope this helps,feel free to ask any other questions
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