Research Article
BibTex RIS Cite

The effect of inhaled corticosteroids in treatment of asthma on the control of diabetes mellitus

Year 2019, Volume: 16 Issue: 2, 295 - 299, 29.08.2019
https://doi.org/10.35440/hutfd.557202

Abstract

Background: We aimed to investigate the effect of inhaled corticosteroids on
diabetes control in asthma-diagnosed diabetic patients.

Methods:
Our study is a retrospective case-control study. Between January 1, 2016 and
January 1, 2017, patients with diabetes mellitus  who visited 
Family Medicine Outpatients  of
Akdeniz University Medical Faculty Hospital and patients with diabetes mellitus  diagnosed with asthma who visitd Chest
Diseases Outpatients were enrolled. Patients who used systemic steroids for any
reason, diabetes mellitus  patients who
did not take regular medication, patients who diagnosed as diabetic
ketoacidosis, and patients  who needed
oral steroids for asthma exacerbation within the last year were excluded from
the study.

Results:
A total number of 138 patients (mean age 59.1±9.6), 44 (31.9%) male and 94
(68.1%) female were included in the study. 68.1% (94) of the patients diagnosed
as  diabetes mellitus  without asthma diagnosis, while 31.9% (44)
were DM diagnosed with asthma diagnosis. The frequency of high blood glucose (p
<0.006) and neuropathy (p <0.001) were significantly higher in the
asthmatic group compared to the non-asthmatic group, whereas the incidence of
nephropathy (p <0.023) were found to be significantly higher in non-asthmatic
group. There was no statistically significant difference in age, hemoglobin
levels and glycated hemoglobin levels between the two groups in our study







Conclusions: In conclusion, the use of low-to-moderate inhaled corticosteroids may
cause an increase in the risk of neuropathy from diabetic complications and
higher blood glucose levels, while not altering glycated hemoglobin levels in
asthmatic patients with diabetes mellitus.

References

  • 1. Türk Toraks Derneği Astım Allerji Çalışma Grubu. Turk Thorac J 2016 (Supplement 1).5-952. Satman İ, İmamoğlu Ş, Yılmaz C, Akalın S, Salman S, Dinççağ N ve Diyabetes Mellitus Çalışma ve Eğitim Grubu. TEMD Diyabetes Mellitus ve Komplikasyonlarının Tanı, Tedavi ve İzlem Kılavuzu-2017. 9. Baskı. Ankara: Bayt Matbaacılık; 2017.s.15. 3. Sullivan PW, Ghushchyan VH, Globe G, Schatz M, Oral Corticosteroid Exposure and Adverse Effects in Asthma, Journal of Allergy and Clinical Immunology 2018; 141(1):110-116.4. Schacke H, Docke W, Asadullah K. Mechanisms involved in the side effects of glucocorticoids. Pharmacology & Therapeutics 2002; 96:23-43.5. Lieberman P, Patterson R, Kunske R. Complications of long-term steroid therapy for asthma. J. Allergy Clin Immunol 1972; 49:329-3366. Skorodin MS. Pharmacotherapy for Asthma and Chronic Obstructive Pulmonary Disease. Arch Intern Med 1993; 153:814-8287. Faul JL, Torney W, Torney V, Burke C. High dose inhaled corticosteroids and dose dependent loss of diabetic control. Brith Med Journal 1998; 317:1491.8. Dendukuri N, Blais L, LeLorier J. Inhaled corticosteroids and the risk of diabetes among the elderly. Br J Clin Pharmacol. 2002; 54:59-64.9. Mattishent K, Thavarajah M, Blanco P, Gilbert D, Wilson AM, Loke YK. Meta-Review: Adverse Effects of Inhaled Corticosteroids Relevant to Older Patients. Drugs. 2014; 74:539-547.10. O’Byrne PM, Rennard S, Gerstein S, Radner F, Peterson S, Lindberg B et al. Risk of new onset diabetes mellitus in patients with asthma or COPD taking inhaled corticosteroids. Respiratory Medicine. 2012; 106:1487-1493.11. Barnes PJ. Inhaled Corticosteroids in COPD: A Controversy. Respiration. 2010; 80:89–95.12. Suissa S, Kezouh A, Ernst P. Inhaled Corticosteroids and the Risks of Diabetes Onset and Progression. Am J Med. 2010;123:1001-1006.13. GINA. 2016-Pocket Guide for Asthma Management and Prevention, GINA Foundation, 2016. Available at: nasthma.org/wp-content/uploads/2016/05/WMS-GINA2016-main-Pocket-Guide.pdf14. Caughey GE, Preiss AK, Vitry AI, Gilbert AL, Roughead EE. Comorbid Diabetes and COPD. Diabetes Care. 2013; 36:3009-3013.15. Helander E. Asthma and Diabetes. Acta Med Scand. 1958; 162:165-174.16. Themeli Y, Ibro M, Dyrmishi L, Klosi J. Prevalence of bronchial asthma in patients with type 2 diabetes mellitus. Endocrine Abstracts. 2014; 35;355 17. Heck S, Al-Shobash A, Rapp D, Le DD, Omlor A, Bekhit A et al. High probability of comorbidities in bronchial asthma in Germany. NPJ Prim Care Respir Med. 2017; 27:28.18. Mansi R, Joshi SV, Pandloskar SR, Dhar HL. Correlation Between Blood Sugar, Cholesterol and Asthma Status. Indian J Allergy Asthma Immunol. 2007; 21(1):31-3419. Mostofizadeh N, Momen T, Saberi M, Reisi M, Hashemi E, Hashemipour M et al. The Prevalence of Asthma in Children under Eighteen Years Old with Type 1 Diabetes Mellitus and Relationship between Control of Diabetes and Severity of Asthma in 2016. Int J Pediatr. 2017; 5:7095-7102.20. Ernst P, Suissa S. Systemic effects of inhaled corticosteroids. Curr Opin Pulm Med 2012; 18:85–89.21. Derendof H, Nave R, Drollman A, Cerasoli F, Wurst W. Pharmacokinetic and pharmacodynamic properties of inhaled corticosteroids in relation to efficay and safety. Eur Respir J. 2006; 28: 1042–1050.22. Köksal N,Büyükbeşe MA, Çetinkaya, İnanaç F. May Inhaled Corticosteroid Use Give Rise to Impaired Glucose Tolerance in Bronchial Asthma?. Dicle Med J. 2005; 32(1):26-30.23. Faul JL, Wilson SR, Chu JW, Canfield J, Kuschner WG. The Effect of an Inhaled Corticosteroid on Glucose Control in Type 2 Diabetes. Clin Med Res. 2009; 7(1/2):14-20.24. Blackburn D, Hux J, Mamdani M. Quanitification of the Risk of Corticosteroid-induced Diabetes Mellitus Among the Elderly. J Gen Intern Med. 2002; 17:717-720.

Astım tedavisinde kullanılan inhaler kortikosteroidlerin diabetes mellitus kontrolüne olan etkisi

Year 2019, Volume: 16 Issue: 2, 295 - 299, 29.08.2019
https://doi.org/10.35440/hutfd.557202

Abstract

Öz.

 

Amaç:
Çalışmamızda astım tanılı diyabet hastalarında inhaler kortikosteroidlerin
diyabet kontrolü üzerine olan etkisini araştırmayı amaçladık.

Materyal ve Metot:
Çalışmamız retrospektif vaka kontrol çalışmasıdır. Çalışmaya 1 Ocak 2016-1 Ocak
2017 tarihleri arasında Akdeniz Üniversitesi Tıp Fakültesi Hastanesi Aile
Hekimliği Polikliniği’ne başvuran diabetes mellitus tanılı hastalar ile Göğüs
Hastalıkları Polikliniği’ne başvuran astım tanılı diabetes mellitus hastaları
alındı. Herhangi bir nedenle sistemik steroid kullanan hastalar, düzenli ilaç
kullanmayan diyabet tanılı hastalar, diyabetik ketoasidoz ile başvuran
hastalar, son 1 yılda oral steroid kullanılmayı gerektiren astım atağı geçiren
hastalar çalışma dışı bırakıldı.

Bulgular:
Çalışmaya ortalama yaşı 59,1±9,6 olan, 44 (%31,9) erkek, 94 (%68,1) kadın
toplam 138 hasta dâhil edildi. Çalışmaya alınan hastaların %68,1 (94)’i astım
tanısı olmayan diabetes mellitus tanılı hasta iken, %31,9 (44)’u astım tanısı
olan diabetes mellitus tanılı hasta idi. Astım tanısı olmayan grup ile astım
tanısı olan grup karşılaştırıldığında kan glukoz (p<0.006) seviyeleri ve
nöropati (p<0.001) görülme sıklığı astım tanısı olan grupta istatistiksel
anlamlı düzeyde yüksek iken, nefropati (p<0.023) görülme sıklığı astım
tanısı olmayan grupta istatistiki olarak anlamlı düzeyde daha yüksek
bulunmuştur. Çalışmamızda her iki grup arasında yaş, hemoglobin düzeyleri ve
glikozillenmiş hemoglobin düzeyleri bakımından istatistiki anlamlı farklılık
tespit edilmedi.











Sonuç:
Sonuç olarak düşük-orta doz inhaler kortikosteroid kullanımı astım tanısı olan
diabetes mellitus hastalarında glikozillenmiş hemoglobin düzeylerinde
değişikliğe neden olmazken, kan glukoz seviyesinde ve diyabete bağlı
komplikasyonlardan nöropati riskinde artışa neden olabilir.

References

  • 1. Türk Toraks Derneği Astım Allerji Çalışma Grubu. Turk Thorac J 2016 (Supplement 1).5-952. Satman İ, İmamoğlu Ş, Yılmaz C, Akalın S, Salman S, Dinççağ N ve Diyabetes Mellitus Çalışma ve Eğitim Grubu. TEMD Diyabetes Mellitus ve Komplikasyonlarının Tanı, Tedavi ve İzlem Kılavuzu-2017. 9. Baskı. Ankara: Bayt Matbaacılık; 2017.s.15. 3. Sullivan PW, Ghushchyan VH, Globe G, Schatz M, Oral Corticosteroid Exposure and Adverse Effects in Asthma, Journal of Allergy and Clinical Immunology 2018; 141(1):110-116.4. Schacke H, Docke W, Asadullah K. Mechanisms involved in the side effects of glucocorticoids. Pharmacology & Therapeutics 2002; 96:23-43.5. Lieberman P, Patterson R, Kunske R. Complications of long-term steroid therapy for asthma. J. Allergy Clin Immunol 1972; 49:329-3366. Skorodin MS. Pharmacotherapy for Asthma and Chronic Obstructive Pulmonary Disease. Arch Intern Med 1993; 153:814-8287. Faul JL, Torney W, Torney V, Burke C. High dose inhaled corticosteroids and dose dependent loss of diabetic control. Brith Med Journal 1998; 317:1491.8. Dendukuri N, Blais L, LeLorier J. Inhaled corticosteroids and the risk of diabetes among the elderly. Br J Clin Pharmacol. 2002; 54:59-64.9. Mattishent K, Thavarajah M, Blanco P, Gilbert D, Wilson AM, Loke YK. Meta-Review: Adverse Effects of Inhaled Corticosteroids Relevant to Older Patients. Drugs. 2014; 74:539-547.10. O’Byrne PM, Rennard S, Gerstein S, Radner F, Peterson S, Lindberg B et al. Risk of new onset diabetes mellitus in patients with asthma or COPD taking inhaled corticosteroids. Respiratory Medicine. 2012; 106:1487-1493.11. Barnes PJ. Inhaled Corticosteroids in COPD: A Controversy. Respiration. 2010; 80:89–95.12. Suissa S, Kezouh A, Ernst P. Inhaled Corticosteroids and the Risks of Diabetes Onset and Progression. Am J Med. 2010;123:1001-1006.13. GINA. 2016-Pocket Guide for Asthma Management and Prevention, GINA Foundation, 2016. Available at: nasthma.org/wp-content/uploads/2016/05/WMS-GINA2016-main-Pocket-Guide.pdf14. Caughey GE, Preiss AK, Vitry AI, Gilbert AL, Roughead EE. Comorbid Diabetes and COPD. Diabetes Care. 2013; 36:3009-3013.15. Helander E. Asthma and Diabetes. Acta Med Scand. 1958; 162:165-174.16. Themeli Y, Ibro M, Dyrmishi L, Klosi J. Prevalence of bronchial asthma in patients with type 2 diabetes mellitus. Endocrine Abstracts. 2014; 35;355 17. Heck S, Al-Shobash A, Rapp D, Le DD, Omlor A, Bekhit A et al. High probability of comorbidities in bronchial asthma in Germany. NPJ Prim Care Respir Med. 2017; 27:28.18. Mansi R, Joshi SV, Pandloskar SR, Dhar HL. Correlation Between Blood Sugar, Cholesterol and Asthma Status. Indian J Allergy Asthma Immunol. 2007; 21(1):31-3419. Mostofizadeh N, Momen T, Saberi M, Reisi M, Hashemi E, Hashemipour M et al. The Prevalence of Asthma in Children under Eighteen Years Old with Type 1 Diabetes Mellitus and Relationship between Control of Diabetes and Severity of Asthma in 2016. Int J Pediatr. 2017; 5:7095-7102.20. Ernst P, Suissa S. Systemic effects of inhaled corticosteroids. Curr Opin Pulm Med 2012; 18:85–89.21. Derendof H, Nave R, Drollman A, Cerasoli F, Wurst W. Pharmacokinetic and pharmacodynamic properties of inhaled corticosteroids in relation to efficay and safety. Eur Respir J. 2006; 28: 1042–1050.22. Köksal N,Büyükbeşe MA, Çetinkaya, İnanaç F. May Inhaled Corticosteroid Use Give Rise to Impaired Glucose Tolerance in Bronchial Asthma?. Dicle Med J. 2005; 32(1):26-30.23. Faul JL, Wilson SR, Chu JW, Canfield J, Kuschner WG. The Effect of an Inhaled Corticosteroid on Glucose Control in Type 2 Diabetes. Clin Med Res. 2009; 7(1/2):14-20.24. Blackburn D, Hux J, Mamdani M. Quanitification of the Risk of Corticosteroid-induced Diabetes Mellitus Among the Elderly. J Gen Intern Med. 2002; 17:717-720.
There are 1 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences
Journal Section Research Article
Authors

Fatih Üzer 0000-0001-9318-0458

Fatih Burak Alparslan This is me

Melahat Akdeniz

Ömer Özbudak This is me 0000-0001-9516-8129

Publication Date August 29, 2019
Submission Date April 23, 2019
Acceptance Date August 1, 2019
Published in Issue Year 2019 Volume: 16 Issue: 2

Cite

Vancouver Üzer F, Alparslan FB, Akdeniz M, Özbudak Ö. Astım tedavisinde kullanılan inhaler kortikosteroidlerin diabetes mellitus kontrolüne olan etkisi. Harran Üniversitesi Tıp Fakültesi Dergisi. 2019;16(2):295-9.

Harran Üniversitesi Tıp Fakültesi Dergisi  / Journal of Harran University Medical Faculty