Abstract

Prolonged corticosteroid use, though vital in treating inflammatory, autoimmune, and allergic disorders, is 
frequently associated with serious metabolic and endocrine complications. Extended exposure to glucocorticoids 
disrupts critical physiological pathways regulating glucose metabolism, bone formation, lipid balance, and hormonal 
secretion. Consequently, patients are at increased risk of developing hyperglycemia, osteoporosis, adrenal 
suppression, and obesity, conditions that significantly impair quality of life and complicate disease management. 
This review comprehensively explores the mechanisms underlying corticosteroid-induced metabolic and endocrine 
disruptions, detailing their clinical manifestations and associated risk factors. It also highlights preventive strategies, 
including patient education, lifestyle modification, and close clinical monitoring, as essential components of long
term management. Furthermore, emerging therapeutic approaches such as corticosteroid-sparing agents and 
selective glucocorticoid receptor modulators (SGRMs) offer promising avenues to reduce systemic toxicity while 
maintaining therapeutic efficacy. Understanding these adverse effects is crucial for clinicians to balance treatment 
benefits against long-term risks, promote safer corticosteroid use, and improve patient outcomes through 
personalized and evidence-based care.