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Steroid-induced hyperglycaemia — GPhC CRA MCQ

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HardEndocrine TherapeuticsSteroid-induced hyperglycaemiaGPhC CRA

A 64-year-old man with type 2 diabetes takes insulin glargine, metformin and ramipril. He is prescribed a reducing course of prednisolone for polymyalgia rheumatica and reports pre-dinner glucose readings above 18mmol/L. What monitoring is required?

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Correct answer: D — More frequent glucose monitoring and prompt diabetes-treatment review during steroid therapy.

Systemic corticosteroids can significantly worsen hyperglycaemia, often later in the day after morning dosing. A patient already on insulin with high readings needs more frequent monitoring and diabetes-treatment adjustment by the clinical team. The monitoring priority is glucose, not thyroid function or INR.

Reference: BNF; NICE CKS