Which adverse effect is commonly associated with long-term prednisolone use in rheumatoid arthritis?

• A. Hyperglycaemia
• B. Hypoglycemia
• C. Hypotension
• D. Hypokalemia

Answer: (A)

Long-term prednisolone affects glucose metabolism, leading to higher blood sugar. It increases hepatic glucose production and reduces how effectively tissues use insulin, and over time can unmask or induce diabetes. That makes hyperglycemia the most common and notable adverse effect with prolonged steroid therapy in rheumatoid arthritis. Hypoglycemia isn’t expected with steroids, since they raise glucose rather than lower it. Hypotension isn’t typical; steroids can cause fluid retention and may raise blood pressure. While there can be electrolyte shifts with steroids, hypokalemia is not the characteristic long-term effect of prednisolone.