Study Suggests Inhaled Corticosteroids Associated with Higher Glucose Levels in Veterans with Diabetes, but Effect was Dose-Dependent
Inhaled corticosteroids are commonly prescribed to patients with both asthma and chronic obstructive pulmonary disease (COPD). Several studies have examined the systemic effects of inhaled corticosteroids, but no study has examined the association between inhaled corticosteroids and serum glucose levels. This prospective cohort study examined the association between inhaled corticosteroids and glucose concentration among Veterans who received care at seven VA primary care clinics between 12/96 and 5/01. Of the 1,698 Veterans in this study, 19% also had self-reported diabetes. Serum glucose measured during routine outpatient clinical practice was the primary outcome measure. Investigators also gathered data on baseline patient characteristics (i.e., gender, education, income) and health history (i.e., diagnosis of diabetes and/or COPD).
Findings show that after controlling for systemic corticosteroid use and other potential confounders, no association was found between inhaled corticosteroids and serum glucose for Veterans without diabetes. However, among Veterans with diabetes, every additional 100 mcg of inhaled corticosteroid dose was associated with increased glucose concentration. Given this association, authors suggest that clinicians anticipate an increase in serum glucose for patients with diabetes who are using inhaled corticosteroids and adjust serum glucose monitoring accordingly.
Slatore C, Bryson C, and Au D. The association of inhaled corticosteroid use with serum glucose concentration in a large cohort. American Journal of Medicine May 2009;122(5):472-478.
This study was funded by HSR&D. Dr. Bryson is supported by an HSR&D Career Development Award, and all authors are part of HSR&D's Northwest Center for Outcomes Research in Older Adults in Seattle.