Shoulder Corticosteroid Injection in Diabetic Patients

Inclusion Criteria

• •Consent to participate in the study.
• •Severe overall pain and night pain: Numerical Rating Scale (NRS) for pain\[8\] above or equal to 60/100; the scale was modified from 0-10 to 0-100 (0 = no pain 100 = unbearable pain).
• •No significant improvement after at least 2 courses of physiotherapy (including direct assistance from a physical therapist with specific exercises, manual therapy, and physical agents in order to reduce inflammation and pain).
• •Clinical signs of subacromial tendinobursitis, with or without signs of rotator cuff tear, defined as positive Neer, Yocum and Hawkins tests\[9-15\]. Pain experienced during the execution of these tests needed to reproduce the type of pain that patients complained the most.
• •No indication for surgery due to the age, concomitant comorbidities or patient's refusal to undergo surgery.
• •Well-controlled type-2 diabetes, defined as:
• •* Fasting and pre-prandial blood glucose levels in the range of 90- 150mg/dL.
• •* Hb1Ac \<64mmol/mol (corresponding to 8%) measured within 6 months.
• •A device for self-measurement of blood sugar levels at home
• •Patients need to have a recent (within 6 months) x-ray and an MRI or ultrasound of the affected shoulder