In a patient with diabetes, what parameter should be monitored when starting systemic corticosteroids?

• A. Blood glucose levels
• B. Blood pressure only
• C. Liver enzymes only
• D. Renal function only

Answer: (A)

Systemic corticosteroids raise blood glucose by increasing hepatic glucose production and reducing peripheral insulin sensitivity. In a patient with diabetes, this can cause significant hyperglycemia soon after starting therapy, so close monitoring of blood glucose is essential. Regular glucose checks allow timely adjustments to insulin or other antidiabetic medications to prevent hyperglycemic crises and keep glycemic control on track during steroid treatment. While steroids can affect other systems—blood pressure, liver enzymes, and renal function may change with therapy—the most immediate and clinically important concern for a diabetic patient starting systemic steroids is managing glucose levels.