The effect of an inhaled corticosteroid on glucose control in type 2 diabetes.

Hdl Handle:
http://hdl.handle.net/10147/95033
Title:
The effect of an inhaled corticosteroid on glucose control in type 2 diabetes.
Authors:
Faul, John L; Wilson, Sandra R; Chu, James W; Canfield, James; Kuschner, Ware G
Affiliation:
Department of Respiratory Medicine, Connolly Hospital, Dublin, Ireland.
Citation:
The effect of an inhaled corticosteroid on glucose control in type 2 diabetes. 2009, 7 (1-2):14-20 Clin Med Res
Journal:
Clinical medicine & research
Issue Date:
Jun-2009
URI:
http://hdl.handle.net/10147/95033
DOI:
10.3121/cmr.2009.824
PubMed ID:
19251584
Abstract:
OBJECTIVE: To determine the effect of inhaled corticosteroid (ICS) therapy on glucose control in adults with type 2 diabetes mellitus and coexisting asthma or chronic obstructive pulmonary disease (COPD). DESIGN: A prospective randomized, double-blind, double-dummy placebo-controlled, crossover investigation of inhaled steroids and oral leukotriene blockers. SETTING: A United States Department of Veterans Affairs Health Care System outpatient setting. PARTICIPANTS: Adults with type 2 diabetes and asthma or COPD. METHODS: Subjects (n=12) were randomized to receive either inhaled fluticasone propionate (440 microg twice daily) and oral placebo, or inhaled placebo and oral montelukast (10 mg/day). After 6 weeks, subjects were switched to the opposite therapy for 6 weeks. The primary outcome measure was the change in the percentage of glycosylated hemoglobin (%HbA1c) at 6 weeks relative to the baseline value. RESULTS: Ten patients completed the study. The difference between the mean within-subject changes in %HbA1c associated with 6-week periods of fluticasone and the mean changes associated with montelukast therapy was small but statistically significant (mean difference=0.25; P<0.025). Neither fluticasone nor oral montelukast therapy for 6 weeks led to a significantly different mean % HbA1c compared with the relevant baseline (mean differences=0.11 and -0.14, respectively). CONCLUSION: The absence of a clinically significant within-subject difference in the changes in %HbA1c associated with fluticasone versus oral montelukast therapy, or between either therapy or baseline does not warrant recommending changes in therapy for asthma or diabetes in patients with these co-morbid conditions. However, we suggest that clinicians carefully monitor blood glucose control when diabetic patients initiate ICS, especially with higher dosages.
Language:
en
MeSH:
Acetates; Administration, Inhalation; Adrenal Cortex Hormones; Aged; Androstadienes; Anti-Asthmatic Agents; Bronchodilator Agents; Cross-Over Studies; Diabetes Complications; Diabetes Mellitus, Type 2; Double-Blind Method; Glucose; Hemoglobin A, Glycosylated; Humans; Male; Middle Aged; Placebos; Pulmonary Disease, Chronic Obstructive; Quinolines; Treatment Outcome
ISSN:
1554-6179

Full metadata record

DC FieldValue Language
dc.contributor.authorFaul, John Len
dc.contributor.authorWilson, Sandra Ren
dc.contributor.authorChu, James Wen
dc.contributor.authorCanfield, Jamesen
dc.contributor.authorKuschner, Ware Gen
dc.date.accessioned2010-03-26T09:47:04Z-
dc.date.available2010-03-26T09:47:04Z-
dc.date.issued2009-06-
dc.identifier.citationThe effect of an inhaled corticosteroid on glucose control in type 2 diabetes. 2009, 7 (1-2):14-20 Clin Med Resen
dc.identifier.issn1554-6179-
dc.identifier.pmid19251584-
dc.identifier.doi10.3121/cmr.2009.824-
dc.identifier.urihttp://hdl.handle.net/10147/95033-
dc.description.abstractOBJECTIVE: To determine the effect of inhaled corticosteroid (ICS) therapy on glucose control in adults with type 2 diabetes mellitus and coexisting asthma or chronic obstructive pulmonary disease (COPD). DESIGN: A prospective randomized, double-blind, double-dummy placebo-controlled, crossover investigation of inhaled steroids and oral leukotriene blockers. SETTING: A United States Department of Veterans Affairs Health Care System outpatient setting. PARTICIPANTS: Adults with type 2 diabetes and asthma or COPD. METHODS: Subjects (n=12) were randomized to receive either inhaled fluticasone propionate (440 microg twice daily) and oral placebo, or inhaled placebo and oral montelukast (10 mg/day). After 6 weeks, subjects were switched to the opposite therapy for 6 weeks. The primary outcome measure was the change in the percentage of glycosylated hemoglobin (%HbA1c) at 6 weeks relative to the baseline value. RESULTS: Ten patients completed the study. The difference between the mean within-subject changes in %HbA1c associated with 6-week periods of fluticasone and the mean changes associated with montelukast therapy was small but statistically significant (mean difference=0.25; P<0.025). Neither fluticasone nor oral montelukast therapy for 6 weeks led to a significantly different mean % HbA1c compared with the relevant baseline (mean differences=0.11 and -0.14, respectively). CONCLUSION: The absence of a clinically significant within-subject difference in the changes in %HbA1c associated with fluticasone versus oral montelukast therapy, or between either therapy or baseline does not warrant recommending changes in therapy for asthma or diabetes in patients with these co-morbid conditions. However, we suggest that clinicians carefully monitor blood glucose control when diabetic patients initiate ICS, especially with higher dosages.-
dc.language.isoenen
dc.subject.meshAcetates-
dc.subject.meshAdministration, Inhalation-
dc.subject.meshAdrenal Cortex Hormones-
dc.subject.meshAged-
dc.subject.meshAndrostadienes-
dc.subject.meshAnti-Asthmatic Agents-
dc.subject.meshBronchodilator Agents-
dc.subject.meshCross-Over Studies-
dc.subject.meshDiabetes Complications-
dc.subject.meshDiabetes Mellitus, Type 2-
dc.subject.meshDouble-Blind Method-
dc.subject.meshGlucose-
dc.subject.meshHemoglobin A, Glycosylated-
dc.subject.meshHumans-
dc.subject.meshMale-
dc.subject.meshMiddle Aged-
dc.subject.meshPlacebos-
dc.subject.meshPulmonary Disease, Chronic Obstructive-
dc.subject.meshQuinolines-
dc.subject.meshTreatment Outcome-
dc.titleThe effect of an inhaled corticosteroid on glucose control in type 2 diabetes.en
dc.contributor.departmentDepartment of Respiratory Medicine, Connolly Hospital, Dublin, Ireland.en
dc.identifier.journalClinical medicine & researchen
dc.description.provinceLeinster-

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