Abstract

BACKGROUND

Steroid-induced hyperglycemia is a significant concern for patients with diabetes who undergo ultrasound-guided sacroiliac joint (SIJ) injections, because corticosteroids impair insulin sensitivity and elevate blood glucose levels. Chromium, a trace mineral essential for glucose metabolism, has been suggested to enhance insulin sensitivity and stabilize blood glucose levels. While previous studies indicate that chromium supplementation may reduce hyperglycemia and analgesic use, further research is needed to confirm its efficacy in patients with diabetes who are receiving steroid therapy.

OBJECTIVES

Our study aimed to evaluate the effects of oral chromium supplementation on steroid-induced hyperglycemia and pain management in patients with diabetes who are undergoing SIJ injections.

STUDY DESIGN

A double-blinded, randomized controlled trial.

SETTING

This study was conducted at Fayoum University Hospitals (June 2024 through May 2025).

METHODS

We randomized 60 patients with diabetes who underwent an SIJ injection. They were randomized into 2 groups: the Chromium Group (n = 30) received 200 μg of oral chromium daily for 45 days postintervention, while the Control Group (n = 30) followed standard diabetes management. Primary outcomes included random blood sugar and hemoglobin A1c levels, while secondary outcomes assessed were hypoglycemic medication use, analgesic consumption, pain scores, and adverse effects.

RESULTS

Our study found that oral chromium supplementation significantly improved glycemic control and reduced the need for hypoglycemic drugs and analgesics in patients with diabetes who underwent steroid therapy. Starting from the postintervention sixth day, there were significant reductions in blood sugar levels and a 40% decrease in hypoglycemic drug use from the first postintervention week (P < 0.05). Analgesia consumption decreased by 30%, with improved pain perceptions noted in Visual Analog Scale pain scores at postintervention months one, 3, and 6 (P < 0.05). These results indicate that chromium is efficacious for managing both glycemia and pain, leading to enhanced treatment outcomes.

LIMITATIONS

Limitations include the relatively small total number of patients, which might limit the ability to generalize the findings to all populations that have diabetes or detect smaller but clinically meaningful effects. The supplementation period of 45 days may not be long enough to observe potential long-term effects of chromium on blood sugar levels or fully assess any delayed adverse effects.

CONCLUSIONS

Chromium supplementation improves glycemic control and reduces analgesic dependence in patients with diabetes who had an SIJ injection. Chromium supplementation therapy is a safe and cost-effective adjunct to standard diabetes management.

MeSH

Diabetes Mellitus, Injections, Blood Glucose, Insulin, Blood, Pain, Pharmaceutical Preparations, Pain Management, Sugars, Hyperglycemia, Analgesics, Therapeutics, Hypoglycemic Agents, Steroids, Glycemic Control