A patient starting systemic corticosteroid therapy asks about common adverse effects. Which statement best reflects a common adverse effect?

• A. Hyperglycemia and increased appetite as part of weight gain
• B. Decreased blood glucose levels
• C. Significant hyponatremia is universal
• D. Severe hypertension is unavoidable

Answer: (A)

Systemic corticosteroids frequently disrupt glucose metabolism and increase appetite. They stimulate hepatic gluconeogenesis and reduce insulin sensitivity, which commonly raises blood glucose levels. At the same time, they can affect central appetite regulation, leading to increased appetite and, over time, weight gain. Fluid retention can contribute to weight as well, but the hallmark combination is hyperglycemia with increased appetite.

The other statements don’t fit as well: decreased blood glucose is not typical with steroids; hyponatremia is not a universal effect and steroids often cause sodium and water retention rather than loss of sodium; severe hypertension can occur but is not unavoidable and varies with dose, duration, and individual risk.