Asthma and chronic obstructive pulmonary disease (COPD) patients who are treated with inhaled corticosteroids may have a significantly higher risk for both the development and progression of diabetes, according to research published in the American Journal of Preventative Medicine.
Analyzing data from more than 380,000 respiratory patients in Quebec, lead investigator Samy Suissa and team discovered a 34 percent increase in the rate of new diabetes diagnoses and diabetes progression in those patients using inhalers. Patients treated with the highest-dose inhalers are at even greater risk, with a 64 percent increase in the onset of diabetes and a 54 percent increase in diabetes progression.
Over the five and a half year study period, more than 30,000 COPD/asthma patients developed a new diagnosis of diabetes, while 2,100 patients diagnosed with diabetes before using inhalers experienced a worsening of their disease that ultimately required upgrading their diabetes care from pills to insulin shots.
“I would say that a lot more attention should first be paid to the lifestyle choices, dietary-wise, that lead to the pro-inflammatory conditions that raise the risk for both type 2 diabetes as well as COPD and asthma,” said Dr. Stuart Weiss, an endocrinologist with the New York University Medical Center, in a recent press release.
Weiss believes the root of the problem is not the steroids but the fact that those who are at risk for diabetes are the same people who have asthma and COPD that require steroid treatment.
“Yes, we do know that steroids increase insulin resistance and that people treated with steroids require more aggressive diabetes management,” Weiss conceded. “But if we don’t generally take an approach that deals with the poor quality of food that people are routinely consuming, the incidence of both these diseases will continue to go up at a dramatic rate.”
Based on the study, researchers suggest that patients treated with high doses of inhaled corticosteroids be assessed for possible hyperglycemia. Further, they believe the use of such high doses of inhalers be limited to situations where the benefit is clear.