Glucocorticoids should be used with caution in patients with which disease process?

Glucocorticoids, while beneficial in treating various conditions due to their anti-inflammatory and immunosuppressive effects, can cause hyperglycemia and may worsen glucose metabolism. In patients with diabetes mellitus, the introduction of glucocorticoids increases the risk of elevated blood sugar levels, complicating the management of their diabetes. These medications can induce insulin resistance, leading to difficulties in controlling blood glucose and potentially requiring adjustments in diabetes management protocols.

In contrast, while glucocorticoids can impact cardiovascular health in terms of fluid retention and blood pressure through mechanisms such as sodium retention, the primary concern with diabetes mellitus stems from their direct effects on glucose metabolism. Other conditions, like heart failure or hypertension, may certainly warrant caution when prescribing glucocorticoids, but the specific and pronounced risk associated with diabetes highlights why this condition is particularly relevant when considering the use of glucocorticoids.