Inhaled Corticosteroids May Up Diabetes in COPD, Asthma Patients

Patients with asthma and chronic obstructive pulmonary disease (COPD) who are treated with inhaled corticosteroids – Flonase®, <"">Advair®, Pulmicort®, Rhinocort®, QVAR®, and Beclovent® – may be looking at a “significantly higher” risk for developing diabetes and, if they have diabetes, exacerbation of that disease, said US News, citing a recent Canadian study.

The study looked at over 380,000 respiratory patients in Quebec in which it was discovered that use of the devices were linked to a 34 percent increase in the rate of new diabetes diagnoses and diabetes progression, said US News. For those patients treated with the higher dose inhalers, there was an increased diabetes risk with a 64 percent increase in diabetes onset and a 54 percent increase in the disease’s progression, noted US News.

“High doses of inhaled corticosteroids commonly used in patients with COPD are associated with an increase in the risk of requiring treatment for diabetes and of having to intensify therapy to include insulin,” the study team noted in a news release, quoted US News.

The researchers, from McGill University and the Lady Davis Research Institute at Jewish General Hospital in Montreal, suggest “patients instituting therapy with high doses of inhaled corticosteroids should be assessed for possible hyperglycemia and treatment with high doses of inhaled corticosteroids limited to situations where the benefit is clear,” quoted US News. The research, led by Samy Suissa, appears in the current issue of the American Journal of Preventive Medicine.

We previously wrote that inhaled corticosteroids include medications such as Flonase®, Advair®, Pulmicort®, Rhinocort®, QVAR®, and Beclovent®, and that the increased risk of developing type 2 Diabetes increases with higher doses. The risk is of significant concern for patients suffering from COPD and is considered less significant for asthmatics. Inhaled corticosteroids are administered in the form of aerosol sprays and micropowders.

The team found that while these inhalers are recommended for only the most seriously ill COPD patients, they tend to be prescribed to many more patients, accounting for about 70 percent of all COPD patients, wrote US News. Of those studied, over 30,000 of the COPD/asthma patients reviewed received a new diagnosis of diabetes over five and a half years of treatment, said US News.

This mean that there exists—based on study results—an onset rate of more than 14.2 out of every 1,000 inhaler patients annually. “These are not insubstantial numbers,” Suissa said, quoted US News. “Over a large population, the absolute numbers of affected people are significant,” Suissa added.

Also, during the study timeframe, about 2,100 patients diagnosed with diabetes prior to inhaler use saw progression of their diabetes that led to their having to increase their care from pills to insulin injections, US News pointed out.

Oral corticosteroids, like prednisone, have long been known to increase the risk of diabetes, but this is the first time the effect has been observed with the inhaled form.

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