Which class of medication can lead to increased blood glucose levels when used inappropriately?

Glucocorticoids are a class of steroid hormones that are commonly used for their anti-inflammatory and immunosuppressive effects. When used inappropriately, such as for long durations or in high doses, glucocorticoids can lead to increased blood glucose levels. This occurs because they stimulate gluconeogenesis in the liver, decrease glucose uptake in peripheral tissues, and counteract the effects of insulin, ultimately resulting in hyperglycemia. This is particularly critical in patients with pre-existing diabetes or those at risk of developing diabetes, as glucocorticoids can exacerbate their condition.

In contrast, insulin is used to lower blood glucose levels in individuals with diabetes, and metformin works primarily to reduce blood glucose levels by enhancing insulin sensitivity and decreasing hepatic glucose production. SGLT2 inhibitors help manage blood glucose by promoting the excretion of glucose in the urine, thereby lowering blood sugar levels. Therefore, while glucocorticoids can lead to increased blood glucose when misused, the other classes mentioned are designed to lower blood glucose levels, highlighting the distinct pharmacological actions of glucocorticoids.