Diabetic Ketoacidosis Following Administration of Cervical Epidural Steroid Injection in a Non-Diabetic

Andrew C. Berry, Matthew E. Tick, Brijesh B. Patel, Cheryl W. O'Malley, Rahman Nakshabendi, Jason Bellardini, Ariel Caplan, Nick A. Berry, Warren L. Reuther III

Abstract


Our case describes a 56-year-old African-American female who underwent fluoroscopy-guided epidural steroid injection for recurrent neck and arm pain. The administration of steroid injections has been shown to diminish peripheral glucose metabolism and to stimulate gluconeogenesis, thus elevating blood glucose concentration and worsening insulin resistance. Though uncommon, diabetic ketoacidosis (DKA) can arise following both epidural steroid treatments in diagnosed diabetics or in cases of coinciding infection. At the time of the epidural injection, the patient showed no signs of acute infection, concomitant drug use or any documented diabetes, all potential causes of DKA. Our case is unique because it describes a documented non-diabetic patient who went into DKA following cervical epidural steroid injection.




J Med Cases. 2014;5(9):495-497
doi: http://dx.doi.org/10.14740/jmc1846w


Keywords


Diabetic ketoacidosis; Diabetes; Epidural steroid injection; Degenerative disc disease

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