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Steroid Glucose Intolerance RA — SCE Rheumatology MCQ

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EasyRheumatoid ArthritisSteroid Glucose Intolerance RASCE Rheumatology

A 60-year-old woman with RA on MTX and Prednisolone develops glucose intolerance. Her HbA1c is 48 mmol/mol (pre-diabetic). What is the most important intervention?

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Correct answer: D — Reduce and ideally withdraw glucocorticoids as they are the main driver of glucose intolerance; optimise DMARD therapy to enable steroid withdrawal

Glucocorticoid-induced glucose intolerance is dose-dependent and potentially reversible with dose reduction. EULAR 2022: minimise steroids. Optimising DMARD/biologic therapy to control RA enables steroid withdrawal. HbA1c monitoring recommended for patients on glucocorticoids.

Reference: EULAR 2022 RA; COMORA 2014