The effect of an inhaled corticosteroid on glucose control in type 2 diabetes.
Affiliation
Department of Respiratory Medicine, Connolly Hospital, Dublin, Ireland.Issue Date
2009-06MeSH
AcetatesAdministration, 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
Metadata
Show full item recordCitation
The effect of an inhaled corticosteroid on glucose control in type 2 diabetes. 2009, 7 (1-2):14-20 Clin Med ResJournal
Clinical medicine & researchDOI
10.3121/cmr.2009.824PubMed ID
19251584Abstract
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
enISSN
1554-6179ae974a485f413a2113503eed53cd6c53
10.3121/cmr.2009.824