Knee Steroid Injection and Blood Sugar Signatur

Study Overview
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Brief Summary
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A prospective, observational study assessing the relationship between HbA1c level and the post-injection blood glucose signature. Participants will be non-diabetic, pre-diabetic, non-insulin dependent and insulin dependent type 2 diabetic patients who will be receiving a knee steroid injection. All of them will be consented a week prior to the injection, when the CGM sensor will be applied to the back of the upper arm. This will be removed a week after the injection. KOOS survey as well as VAS will be administered. Adverse events (e.g., change in medication or hospitalization) will be monitored throughout the study.

Official Title
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Identifying Variables Associated With Steroid-Induced Hyperglycemia Following Intra-articular Knee Injections Among Diabetic Patients

Conditions
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Diabetes, Knee Osteoarthritis

Intervention / Treatment
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* Drug: 40 mg Triamcinolone acetonide


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients at the Parkland Outpatient Clinic Indication for unilateral knee joint steroid injection for the treatment of knee joint osteoarthritis Exclusion Criteria: Less than 18 years old HbA1c > 12.0% steroid exposure in the 3 months prior to Visit 1 3 or more steroid injections in the preceding 12 months known contraindication to steroid injection (adverse reaction or allergy, active infection, INR > 3.0) lack of improvement with prior knee steroid injection change in diabetic medication regimen in the last 1 month significant change in diet within the last 1 month current use of aspirin allergy to adhesive planned MRI, XR, or CT during the 2-week study period

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Diabetic with Knee Osteoarthritis<br>HbA1c between 6.5% - 12.0% in the 3 months prior to Visit 1 | Drug: 40 mg Triamcinolone acetonide<br>* Unilateral knee steroid injection<br>|
| Pre-diabetic with Knee Osteoarthritis<br>HbA1c between 5.6% - 6.4% in the 3 months prior to Visit 1 | Drug: 40 mg Triamcinolone acetonide<br>* Unilateral knee steroid injection<br>|
| Non-diabetic with Knee Osteoarthritis<br>HbA1c < 5.6% in the 3 months prior to Visit 1 | Drug: 40 mg Triamcinolone acetonide<br>* Unilateral knee steroid injection<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Post-injection glucose levels | Blood glucose levels after injection of steroid to the knee | 1 week | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Post-injection adverse events | Adverse events after injection of steroid to the knee | 1 week | 
| KOOS Knee survey | KOOS Knee survey administered before and after steroid injection to the knee | 2 weeks |