In which condition should glucocorticoids be used cautiously?

Glucocorticoids should be used cautiously in diabetes mellitus primarily because these agents can significantly influence blood glucose levels. Glucocorticoids possess a hyperglycemic effect, which means they can increase blood sugar levels by promoting gluconeogenesis and decreasing cellular glucose uptake. For patients with diabetes, managing blood glucose is critical to prevent hyperglycemic episodes and associated complications. Thus, careful monitoring and possible adjustments in diabetes medications are necessary when corticosteroids are prescribed.

Conditions such as thyroid disease and chronic fatigue syndrome may not have the same level of impact from glucocorticoids as seen in diabetes. In the case of hypertension, while glucocorticoids can potentially exacerbate this condition as they may cause fluid retention and increase blood pressure, the level of caution needed is typically not as pronounced as in diabetes mellitus where blood sugar control is paramount. Therefore, the need for cautious usage of glucocorticoids in diabetes is primarily due to their profound effect on glucose metabolism, which directly impacts the disease management of diabetes.