The most problematic and difficult to deal with is the abnormal blood sugar that occurs after the use of glucocorticoids. These patients have to use glucocorticosteroids in supraphysiological doses because of asthma, hematological diseases, rheumatic diseases, etc., resulting in abnormal blood glucose and even progression to diabetes mellitus, adding to the existing disease. Although some cases are unavoidable, I think it is very important to enhance non-endocrinologists’ awareness of the side effects of glucocorticoid use and to let patients know how to grasp some principles in the treatment of various diseases that require glucocorticoids, so as to prevent or alleviate and treat such blood glucose abnormalities in a timely manner. So, what is glucocorticoid? It is what we usually call “hormone”. Glucocorticoids are physiologically secreted by the adrenal cortex of our body and regulate the metabolism of sugar, fat, protein and water and salt, and have important effects on the functions of various tissues and organs. At present, there are many types of glucocorticoids in clinical practice, such as long-acting dexamethasone and betamethasone, medium-acting prednisone and short-acting cortisone, etc. The dosage forms include injections, tablets, eye drops, sprays and ointments, etc. When applying glucocorticoids, different drugs, dosage forms and doses can be selected according to the condition and duration of the disease. In clinical treatment, glucocorticoids are divided into two categories: 1) acute and chronic adrenocortical insufficiency, anterior pituitary hypoplasia and glucocorticoid replacement therapy after subtotal adrenalectomy, which uses small doses and plays a physiological role. Generally no side effects will occur. 2.Severe infections and inflammatory diseases (such as toxic bacillary dysentery, toxic pneumonia, sepsis, tuberculous meningitis, encephalitis, pericarditis, rheumatic valvulitis, etc.); autoimmune diseases (rheumatic fever, rheumatic myocarditis, rheumatic and rheumatoid arthritis, systemic lupus erythematosus, polyarteritis nodosa) and allergic diseases (serum sickness, kwashiorkor fever, drug allergy, contact dermatitis, angioneurotic edema, etc.); infectious toxic shock and anaphylaxis; hematological diseases (acute lymphoblastic leukemia, aplastic anemia, thrombocytopenia, etc. in children); wheezing bronchitis and bronchial asthma; or local application (e.g. contact dermatitis, eczema, psoriasis, keratitis and iritis, etc.), which require larger supraphysiologic doses with greater side effects. The adverse effects of glucocorticoids are many, such as inducing or aggravating infections, osteoporosis, neuropsychiatric abnormalities, muscle atrophy and developmental delay in children, aggravating or inducing gastrointestinal ulcers, and most importantly, metabolic disorders: pharmacogenic hyperadrenocorticism syndrome due to drug overdose, with clinical manifestations such as edema, hypokalemia, hypertension, diabetes mellitus, thinning of the skin, full moon face, buffalo’s back, centripetal obesity, hirsutism, acne. The clinical manifestations include edema, hypokalemia, hypertension, diabetes mellitus, thinning of the skin, full moon face, buffalo back, centripetal obesity, hirsutism and acne. Therefore, when starting glucocorticosteroids for these diseases, doctors should explain the possible side effects to patients, take calcium and vitamin D supplements to prevent osteoporosis, give gastric mucosa protectors, and instruct patients to pay attention to oral hygiene to prevent infections. For patients without previous diabetes, it is also necessary to start monitoring blood glucose as early as possible and deal with elevated blood glucose in a timely manner; for patients with existing diabetes, it is even more important to adjust the glucose-lowering treatment plan in a timely manner to prevent the further aggravation of wheezing bronchitis and aspiration pneumonia due to elevated blood glucose, or the occurrence of various infections and large and small blood vessel complications during the treatment of rheumatic diseases. It should be noted that different dosage forms, different dosing times and intervals make the peak concentration of drugs in the body appear at different times, so the glucose raising effect of glucocorticoids also appears at different times, for example, many patients have their blood glucose rise mainly in the afternoon to bedtime. Therefore, in order to avoid missing diagnosis, all-weather and multi-point blood glucose monitoring should be carried out. When formulating the glucose-lowering treatment plan, the time and peak period of hormone effect should be fully considered, and the dose of glucose-lowering drugs for three meals should be scientifically arranged. For patients who take hormone in the morning, the dose arrangement of glucose-lowering drugs is usually: the dose of Chinese food > the dose of dinner > the dose of breakfast. In addition, blood sugar abnormalities caused by glucocorticoids in patients without previous diabetes will gradually decrease or even return to normal with the reduction or even discontinuation of medication, and blood sugar in patients with diabetes will also gradually decrease, so sugar lovers need not worry too much, but they should pay attention to timely monitoring of blood sugar and timely adjustment of the dosage of glucose-lowering drugs. For patients who need to take a large amount of glucocorticoids for a long time, they should strictly control their diet, strengthen postprandial exercise, monitor their blood sugar more often, and make the best treatment plan to control their blood sugar within the ideal range to prevent various diabetic complications. Patients should pay attention to avoid catching cold and flu, eat a light diet, low salt, low sugar, high protein diet and add potassium chloride to maximize the therapeutic effect of glucocorticoids and minimize the damage of side effects to the body.