Systemic corticosteroids have contraindications in which of the following conditions?

• A. Pregnancy
• B. Peptic ulcer disease
• C. Diabetes
• D. All of the above

Answer: (D)

Systemic corticosteroids carry effects that can worsen pregnancy outcomes, GI healing, and glucose control, so their use is avoided when these conditions are present. In pregnancy, steroids cross the placenta and can affect fetal development and growth, making use risky unless benefits clearly outweigh risks. In peptic ulcer disease, steroids can impair gastric mucosal integrity and increase the risk of ulcers and GI bleeding, especially if NSAIDs are involved. In diabetes, glucocorticoids raise blood glucose by promoting gluconeogenesis and causing insulin resistance, worsening glycemic control. Because each of these situations poses a meaningful risk with systemic steroids, all of these conditions are considered contraindications. If a systemic option is truly needed, a clinician would weigh benefits against risks and consider alternatives or close monitoring.