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The effect of an inhaled corticosteroid on glucose control in type 2 diabetes.
Faul, John L Wilson, Sandra R Chu, James W Canfield, James Kuschner, Ware G
Faul, John L
Wilson, Sandra R
Chu, James W
Canfield, James
Kuschner, Ware G
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Advisors
Editors
Other Contributors
Date
2009-06
Date Submitted
Keywords
Other Subjects
Subject 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
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
Planned Date
Start Date
Collaborators
Principal Investigators
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19251584.pdf
Adobe PDF, 379.91 KB
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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
ISSN
1554-6179
eISSN
ISBN
DOI
10.3121/cmr.2009.824
PMID
19251584