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Oral steroid diabetes warning — GPhC CRA MCQ

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HardRespiratory TherapeuticsOral steroid diabetes warningGPhC CRA

A patient with type 2 diabetes controlled on metformin starts prednisolone 40 mg each morning for five days. Her fasting glucose remains 6.8 mmol/L. When is the single most informative additional daily capillary-glucose check?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Before the evening meal

Once-daily morning prednisolone typically leaves fasting glucose relatively normal and produces a rise through the afternoon and evening. The NHS guidance therefore includes a pre-evening-meal check, which is more informative here than another fasting result. If readings rise, monitoring intensity and treatment are adjusted according to the clinical pathway.

Reference: NHS Scotland Right Decisions, Steroids and diabetes inpatients: https://www.rightdecisions.scot.nhs.uk/diabetes-endocrinology/diabetes/steroids-and-diabetes-inpatients/