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Steroid-induced hyperglycaemia — SCE Endocrinology MCQ

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ModerateDiabetesSteroid-induced hyperglycaemiaSCE Endocrinology

A 69-year-old man with type 2 diabetes starts prednisolone for polymyalgia rheumatica. Pre-lunch glucose is 8 mmol/L, pre-evening meal glucose is 19 mmol/L and bedtime glucose is 16 mmol/L. What is the most likely biochemical pattern?

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Correct answer: E — Predominant afternoon and evening hyperglycaemia

Once-daily morning glucocorticoids characteristically drive afternoon and evening hyperglycaemia. This profile differs from basal insulin deficiency, which more often gives fasting hyperglycaemia. Recognising the pattern helps match therapy to steroid timing.

Reference: JBDS Steroid Hyperglycaemia Guideline