Cortisol plays a key role in mobilizing substances needed for cellular metabolism and stimulates gluconeogenesis or the formation of glucose from noncarbohydrate sources, such as amino acids or free fatty acids in the liver. In addition, cortisol enhances the elevation of blood glucose levels that is promoted by other hormones, such as epinephrine, glucagon, and growth hormone. The effects of cortisol are considered to be permissive for the actions of other hormones. Cortisol also inhibits the uptake and oxidation of glucose by many body cells. Overall, the cortisol-induced increase in carbohydrate metabolism serves to energize the body to cope with the stressor.
A middle-aged female is presented with COPD, respiratory failure, and prediabetes is being treated with systemic corticosteroids for acute bronchitis. Since starting steroid therapy, her blood glucose levels have remained around 190 mg/dL, and she has a slow-healing wound on her arm. She does not normally require insulin. Which pathophysiological mechanism best explains the delayed wound healing in this patient?
A. Cortisol activation leads to increased insulin sensitivity and enhanced collagen production.
B. Elevated cortisol levels cause insulin resistance, impaired leukocyte function, and decreased collagen synthesis.
C. Acute hypoglycemia resulting in reduced tissue perfusion and delayed cellular repair.
D. Increased parasympathetic nervous system activity causing accelerated tissue regeneration.