## 4 Discussion
\begin{table}
\begin{tabular}{c c c c c c} \hline \hline  & **Baseline vs. 1 Month** & \multicolumn{2}{c}{**Baseline vs. 2 Months**} & \multicolumn{2}{c}{**Baseline vs. 3 Months**} \\ \hline
**Outcomes** & **MD (95\% CI)** & \(p\)**-Value** & **MD (95\% CI)** & \(p\)**-Value** & **MD (95\% CI)** & \(p\)**-Value** \\ \hline
**SPADI Score** & 1.63 (1.13, 2.12) & 0.0001 & 2.73 (1.99, 3.46) & 0.0001 & 4.19 (3.47, 4.91) & 0.0001 \\
**Flexion ROM (deg.)** & 28.96 (-36.9, 94.81) & 0.99 & 21.25 (-45.0, -87.47) & 0.99 & 3.96 (-61.8, 69.69) & 0.99 \\
**Abduction ROM (deg.)** & -6.25 (-11.0, -1.46) & 0.005 & \(-\)11.67 (-19.0, -4.29) & 0.0004 & \(-\)20.21 (-29.1, -11.3) & 0.0001 \\
**FBG (mg/dL)** & 0.01 (-3.69,3.69) & 0.99 & \(-\)33.13 (-41.3, -25.0) & 0.0001 & \(-\)48.75 (-62.2, -35.3) & 0.0001 \\
**PPBG mg/dL** & 0.01 (-7.25,7.25) & 0.99 & \(-\)50.83 (-64.3, -37.4) & 0.0001 & \(-\)85.0 (-103.3, -66.7) & 0.0001 \\
**HDA1c\%** & - & - & - & -2.18 (-2.67, -1.68) & 0.0001 \\ \hline \hline \end{tabular}
\end{table} 
Table 3: Pairwise Comparisons for Group A Pretreatment, after 1 Month, 2 Months and 3 Months \(\mathbf{\ast}\). that could be transmitted without loss of energy and their fine and repetitive stimulations, which effectively reduced pain [37]. Shock wave stimulations could generate blood vessels around an affected region, which eventually stimulate and reactivate the tendons' healing process and the tissues around them, thereby stabilizing the tissues [38]. Additionally, the shockwaves enhanced the secretion of substances that induce lymph-angiogenesis through the up-regulation of vascular endothelial growth factor expression and basic fibroblast growth factor [39]. In the present study, the side effects of both treatment protocols were assessed through the glucose triad (the fasting, postprandial glucose levels, and HbA1c), which seems to be the best assessment tool of glycemic control in patients with type 2 diabetes; this was supported in a recent study concluding that the measurement of HbA1c was the best method for assessing blood glucose control and for the prediction of microvascular complications [40]. The current study results not only reveal a significant increase in FBG, PPBG, and HbA1c posttreatment measurements compared with pretreatment measurements in the group (A) (with a maximum increase in the measurements which was performed at three months after the intervention), but there was also a significant decrease in the postintervention measurements of FBG, PPBG, and HbA1c compared with those pretreatment measurements in group B only. Additionally, there was no significant difference between the two groups in FBG and PPBG after one month of treatment, while there was a significant difference between the groups in FBG, PPBG and HbA1c after two and three months of treatment. The present study results revealed that the shock wave therapy had superior results to the intraarticular injection group after two and three months of intervention for all glucose triad measures. This agreed with a previous study, which reported that diabetic patients and patients with glucose intolerance might exhibit higher blood glucose levels while taking glucocorticoids, leading to increased difficulty with glycemic control [41]. The higher blood glucose levels associated with the intra-articular corticosteroids might be due to the systemic absorption of some of the corticosteroid molecules and might cause various effects depending on the dose, the solubility of the preparation, and the number of joints injected [41]. Otherwise, ESWT was likely a safe treatment for many musculoskeletal disorders with minimal or no complications [42]. The present study results contrasted with another retrospective study with a relatively small sample size that concluded that steroid intra-articular injection led to a greater elevation in blood glucose one day after steroid injection [43].