Significant weight gain, thirst, and frequent urination after starting prednisolone likely indicate which adverse effect?

• A. Hyperglycaemia
• B. Hyperkalemia
• C. Hypertension
• D. Hypoglycaemia

Answer: (A)

Prednisolone is a glucocorticoid that raises blood glucose by increasing hepatic gluconeogenesis, reducing glucose uptake in muscle and fat, and opposing insulin action. When glucose levels rise, the kidneys excrete more glucose, causing osmotic diuresis, which leads to frequent urination. The resulting dehydration and high plasma osmolality trigger increased thirst. Together, weight gain (often from increased appetite and fluid retention) plus thirst and polyuria after starting prednisolone point to hyperglycemia, sometimes steroid-induced diabetes. Hyperkalemia isn’t a typical effect of this pattern ( steroids can even cause potassium loss, i.e., hypokalemia); hypertension can occur with steroids but doesn’t explain the thirst and urination as clearly. Hypoglycemia would present with sweating, shakiness, and confusion rather than increased thirst and urination.