We report the hospitalization of four patients who experienced significant consequences from delayed detection of glucocorticoid induced hyperglycaemia (GCIH) due to inadequate screening in the outpatient setting. Patients were identified through the incident reporting system at a tertiary care hospital over two years. A 56 year-old male with glioblastoma multiforme and a cutaneous drug reaction was managed by multiple specialities which continued and adjusted the dose of glucocorticoid for varying indications without screening for GCIH. Subsequent hospitalization with sepsis and confusion revealed long standing severe hyperglycaemia as a precipitant. A 65 year-old female with mouth ulcers was prescribed dexamethasone mouthwash. Due to incomplete administration instructions, ingestion of mouthwash resulted in unintentional overdose leading to hospitalization. A 57 year-old male had undiagnosed diabetes prior to initiation of glucocorticoids with chemotherapy. Additionally, delay in work-up of GCIH during follow up for metastatic rectal carcinoma led to hospitalization with Hyperosmolar Hyperglycaemic State. A 69 year-old male with pre-existing diabetes on oral hypoglycaemic agents, was not advised to intensify glucose monitoring whilst on glucocorticoids with chemotherapy for relapsing haematological malignancy. He died two months after hospitalization for sepsis in the setting of severe symptomatic hyperglycaemia. Although GCIH is a well-known adverse effect of glucocorticoids, and has been reviewed extensively in inpatients, its incidence in outpatients is not well described. There is a need for improvement of screening and managing GCIH in outpatients. Patient centred education with written instructions about medication administration and monitoring for adverse effects of GCIH are required. Organizational guidelines on screening and managing GCIH in outpatients and healthcare provider awareness are also required to decrease hospitalization with GCIH. As such, our hospital has sought patient feedback and implemented these strategies. There is a need for observational studies to describe the incidence of hospitalization with GCIH and its associations.