For disorders treated with glucocorticoids, which lab parameter would you most likely monitor to catch a steroid-induced complication?

For disorders treated with glucocorticoids, which lab parameter would you most likely monitor to catch a steroid-induced complication?

• A. Potassium
• B. Glucose
• C. Hemoglobin A1c
• D. Serum calcium

Answer: (B)

Glucocorticoids raise blood glucose by promoting hepatic gluconeogenesis and reducing peripheral glucose uptake, so watching glucose levels is the key to catching steroid-induced hyperglycemia or diabetes early. This is especially important with high-dose or long-term therapy, and in patients who already have diabetes. While other lab changes can occur—potassium shifts, bone demineralization leading to osteoporosis, or longer-term shifts reflected in HbA1c—the most immediate and clinically relevant concern is hyperglycemia. HbA1c reflects average glucose over months and isn’t as useful for detecting new-onset steroid-induced hyperglycemia, and calcium monitoring is more about bone health than acute glucose issues.

Glucocorticoids raise blood glucose by promoting hepatic gluconeogenesis and reducing peripheral glucose uptake, so watching glucose levels is the key to catching steroid-induced hyperglycemia or diabetes early. This is especially important with high-dose or long-term therapy, and in patients who already have diabetes. While other lab changes can occur—potassium shifts, bone demineralization leading to osteoporosis, or longer-term shifts reflected in HbA1c—the most immediate and clinically relevant concern is hyperglycemia. HbA1c reflects average glucose over months and isn’t as useful for detecting new-onset steroid-induced hyperglycemia, and calcium monitoring is more about bone health than acute glucose issues.