Why Steroids Are Best Avoided

STORY AT-A-GLANCE

  • Steroids can be administered either topically through a cream or ointment, orally or by injection. Steroids work by inhibiting the production of inflammatory chemicals, thereby reducing symptoms associated with inflammation
  • Three of the most common side effects, even from short term use, are osteoporosis (reduced bone density), cataracts and an increased risk of diabetes. However, more serious effects such as life-threatening sepsis have also been reported
  • In one 2019 study, 8% of patients with osteoarthritis of the hip or knees who received one to three steroid injections ended up worse. Adverse effects were observed in 10% of those with OA in the hip and in 4% of those with OA in the knees
  • In another study, intra-articular corticosteroid injections more than doubled the cartilage volume loss compared to placebo (−0.21 millimeters versus −0.10 mm), while having no impact on knee pain at two-year follow-up
  • When using steroids for an extended period of time, abruptly stopping the drug can trigger adverse and potentially even lethal effects, depending on how long you’ve been taking the medication

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Study Finds Bariatric Surgery Lowers Gestational Diabetes Risk

Obese women who have weight loss surgery before they get pregnant are three times less likely to develop gestational diabetes and are also less likely to require a cesarean section, a new study finds.

Weight loss (bariatric) surgery limits the amount of food a person can consume or digest.

U.S. researchers compared rates of gestational diabetes and related outcomes such as cesarean delivery among 346 obese women who had bariatric surgery before pregnancy and 354 obese women who had bariatric surgery after delivery. Most of the women in the study had a gastric bypass operation, with some opting for an adjustable band procedure.

Rates of gestational diabetes were 8 percent for those who had the surgery before pregnancy and 27 percent for those who had the surgery after delivery. Rates of cesarean delivery were 28 percent and 43 percent, respectively.

Makary and colleagues noted that most of the women who underwent weight-loss surgery did not wait the recommended two years afterwards before delivering a baby.

The study appears in the August issue of the Journal of the American College of Surgeons.

“Despite a growing body of evidence supporting the safety and efficacy of bariatric surgery in reversing obesity-related complications, few candidates for the procedure are referred to a surgeon to discuss their options,” senior author Dr. Martin Makary, an associate professor of surgery at Johns Hopkins University School of Medicine, said in a journal news release.

Like all operations, however, bariatric surgery is not without risk. Potential complications, for example, include blood clots, infection, respiratory arrest, gastrointestinal bleeding, and death, according to the American Society for Metabolic & Bariatric Surgery.