Comparative Effect of Inhaling Corticosteroids in Different Doses and Durations with risk of Diabetes Mellitus Type 2 in Chronic Asthma Patients at FMH & Social Security Hospital Lahore
Keywords:
Comparative Effect of Inhaling Corticosteroids, risk of Diabetes Mellitus, Chronic Asthma Patients, FMH, Social Security Hospital LahoreAbstract
Asthma is an assorted disorder categorized by wonted inflammation and augmented airway hyper-responsiveness. Traditionally viewed as a primary lung complaint, it's now known that asthma is accompanying with extrapulmonary comorbidities analogous as obstructive sleep apnea pattern (OSAS) and systemic conditions like diabetes mellitus (DM) and metabolic pattern(Lambrecht et al., 2019) According to Fireman, asthma is a contemporary seditious airway complaint, generally managed with inhaled corticosteroids(ICS) still, achieving asthma control remains grueling in patients with severe asthma, who represent 5 to 10 of asthma cases, indeed when using high boluses of ICS and other anti-inflammatory specifics medications. Type 2 Diabetes Mellitus (DM) is marked by the failure to regulate blood glucose due to a combination of insulin resistance and ineffective pancreatic beta cells. This pathogenesis frequently leads to diabetic dyslipidemia, characterized by increased tube triglycerides, remnant lipoproteins, and small thick low- viscosity lipoprotein, as well as dropped high- viscosity lipoprotein, adipose liver complaint, and an accustomed seditious state. (Talpur et al., 2022) Recent investigation indicates a link between gobbled corticosteroid (ICS) remedy and insulin resistance, hyperglycemia, and diabetes in cases with asthma and COPD. Cases with type- 2 diabetes using ICS for respiratory conditions tend to have poorer glycemic control and advanced glycated hemoglobin (HbA1c) situations compared to those not taking ICS (Paul et al., 2009) The advance of inhaled corticosteroids for respiratory conditions, firstly for asthma and subsequently COPD, depicted a significant breakthrough by letting effective treatment with less pilules and downgraded systemic exposure to the medicine (García-Marcos et al., 2023) Inhaled corticosteroids have significantly excelled asthma treatment due to their superior pharmacokinetic properties . The superlative inhaled corticosteroid should have better lung residence time, high natural activity, low oral bioavailability, and high systemic concurrence. presently, five corticosteroids are available for application in the management of asthma 1) triamcinolone acetonide (TAA), 2) flunisolide, 3) beclomethasone dipropionate(BDP), 4) budesonide, and 5) fluticasone propionate(Derendorf, 1997) Also recent trainings now proved that high- dose inhaled corticosteroid remedy or not taking duly the inhaled corticosteroids leads to disturbances in glucose metabolism which leads to hyperglycemia and consequently affluences the peril of onset of diabetes mellitus type 2 therefore the adverse effects of hyperglycemia have been well proved(Lodha & Kabra, 2009)
References
Aït-Khaled, N., & Enarson, D. A. (2006a). How to diagnose asthma and determine the degree of severity of the disease. Int J Tuberc Lung Dis, 10(3), 252-255.
Aït-Khaled, N., & Enarson, D. A. (2006b). How to diagnose asthma and determine the degree of severity of the disease [Educational Series: Asthma. Serialised guide. Management of asthma: the essentials of good clinical practice. Number 2 in the series]. The International Journal of Tuberculosis and Lung Disease, 10(3), 252-255.
Axelsson, I., Naumburg, E., Prietsch, S. O., & Zhang, L. (2019). Inhaled corticosteroids in children with persistent asthma: effects of different drugs and delivery devices on growth. Cochrane Database Syst Rev, 6(6), Cd010126. https://doi.org/10.1002/14651858.CD010126.pub2
Blackburn, D., Hux, J., & Mamdani, M. (2002). Quantification of the risk of corticosteroid-induced diabetes mellitus among the elderly. Journal of General Internal Medicine, 717-720.
Brunton, S. (2016). Pathophysiology of Type 2 Diabetes: The Evolution of Our Understanding. J Fam Pract, 65(4 Suppl).
Chin-Chung Shu, Y.-F. W., Kuang-Hung Chen, Shulin Chuang, Ya-Hui Wang, Cheng-Yi Wang, Hao-Chien Wang. (2022). Inhaled Corticosteroids Increase Risk of Nontuberculous Mycobacterial Lung Disease: A Nested Case-Control Study and Meta-analysis. The Journal of Infectious Diseases, Pages 627–636.
Dendukuri, N., Blais, L., & LeLorier, J. (2002). Inhaled corticosteroids and the risk of diabetes among the elderly. British journal of clinical pharmacology, 59-64.
Derendorf, H. (1997). Pharmacokinetic and pharmacodynamic properties of inhaled corticosteroids in relation to efficacy and safety. Respiratory medicine, 91, 22-28.
Ducharme, F. M., Ni Chroinin, M., Greenstone, I., & Lasserson, T. J. (2010). Addition of long-acting beta2-agonists to inhaled steroids versus higher dose inhaled steroids in adults and children with persistent asthma. Cochrane Database Syst Rev(4), Cd005533. https://doi.org/10.1002/14651858.CD005533.pub2
Felix J.F. Herth, F. J. F. H. (2015). Respiration, Diabetes. Current Perspectives on the Contribution of Inhaled Corticosteroids to an Increased Risk for Diabetes Onset and Progression in Patients with Chronic Obstructive Pulmonary Disease, 66-75.
Galicia-Garcia, U., Benito-Vicente, A., Jebari, S., Larrea-Sebal, A., Siddiqi, H., Uribe, K. B., Ostolaza, H., & Martín, C. (2020). Pathophysiology of Type 2 Diabetes Mellitus. Int J Mol Sci, 21(17). https://doi.org/10.3390/ijms21176275
García-Marcos, L., Chiang, C. Y., Asher, M. I., Marks, G. B., El Sony, A., Masekela, R., Bissell, K., Ellwood, E., Ellwood, P., Pearce, N., Strachan, D. P., Mortimer, K., & Morales, E. (2023). Asthma management and control in children, adolescents, and adults in 25 countries: a Global Asthma Network Phase I cross-sectional study. Lancet Glob Health, 11(2), e218-e228. https://doi.org/10.1016/s2214-109x(22)00506-x
Kaarthikeyani Sankaravadivelu, P. V. R., Rajesh Bala. (2019). HbA1c Levels in Children with Persistent Asthma on Inhaled Corticoids: A Descriptive Cohort Study. JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, pp. SC15 – SC17.
Kelly, H. W., & Nelson, H. S. (2003). Potential adverse effects of the inhaled corticosteroids. J Allergy Clin Immunol, 112(3), 469-478; quiz 479.
Kew, K. M., Quinn, M., Quon, B. S., & Ducharme, F. M. (2016). Increased versus stable doses of inhaled corticosteroids for exacerbations of chronic asthma in adults and children. Cochrane Database of Systematic Reviews(6).
Khateeb, J., Fuchs, E., & Khamaisi, M. (2019). Diabetes and lung disease: an underestimated relationship. Review of Diabetic Studies, 15(1), 1-15.
Lambrecht, B. N., Hammad, H., & Fahy, J. V. (2019). The cytokines of asthma. Immunity, 50(4), 975-991.
Lipworth, B. J. (1999). Systemic adverse effects of inhaled corticosteroid therapy: A systematic review and meta-analysis. Archives of Internal Medicine, 941-955.
Lodha, R., & Kabra, S. K. (2009). Do inhaled corticosteroids adversely influence glucose metabolism. Indian Pediatr, 46(4), 293-294.
Mattera, C. J. (2002). Diabetes, Part 1. Understanding the pathophysiology of diabetes mellitus. Jems, 27(3), 106-114, 116-124; quiz 126-107.
National Diabetes Data, G., National Institute of, D., Digestive, & Kidney, D. (1995). Diabetes in America. National Institutes of Health, National Institute of Diabetes and Digestive ….
Paul, S., Coleman, R. L., Price, H. C., & Farmer, A. J. (2009). Predicting 6-year mortality risk in patients with type 2 diabetes: response to Wells et al. Diabetes Care, 32(5), e60; author reply e61. https://doi.org/10.2337/dc09-0183
Peters, S. P. (2006). Safety of inhaled corticosteroids in the treatment of persistent asthma. J Natl Med Assoc, 98(6), 851-861.
Petrisko, M. A., Skoner, J. D., & Skoner, D. P. (2008). Safety and efficacy of inhaled corticosteroids (ICS) in children with asthma. J Asthma, 45 Suppl 1, 1-9. https://doi.org/10.1080/02770900802631361
Pu, X., Liu, L., Feng, B. et al. (2021). Association between ICS use and risk of hyperglycemia in COPD patients: systematic review and meta-analysis. Respir Res 22,.
Pu, X., Liu, L., Feng, B., Zhang, Z., & Wang, G. (2021). Association between ICS use and risk of hyperglycemia in COPD patients: systematic review and meta-analysis. Respiratory Research, 1-10.
Ramsahai, J. M., Hansbro, P. M., & Wark, P. A. B. (2019). Mechanisms and Management of Asthma Exacerbations. Am J Respir Crit Care Med, 199(4), 423-432. https://doi.org/10.1164/rccm.201810-1931CI
Rogers, L., & Reibman, J. (2012). Stepping down asthma treatment: how and when. Curr Opin Pulm Med, 18(1), 70-75. https://doi.org/10.1097/MCP.0b013e32834db017
Samraj, G. P., & Kuritzky, L. (2000). Inhaled corticosteroids: 2. Systemic toxicity. Hosp Pract (1995), 35(6), 35-38.
Skyler, J. S. (2004). Diabetes mellitus: pathogenesis and treatment strategies. J Med Chem, 47(17), 4113-4117. https://doi.org/10.1021/jm0306273
Slatore, C. G., Bryson, C. L., & Au, D. H. (2009). The association of inhaled corticosteroid use with serum glucose concentration in a large cohort. American Journal of Medicine, 472-478.
Talpur, A. S., Kavanoor Sridhar, K., Shabbir, K., Amba-Ambaiowei, E. E., Hasan, R. M., Douedari, Z., Hussain, N., Bader, S., Mirza, S., & Hafizyar, F. (2022). Restrictive Pulmonary Disease in Diabetes Mellitus Type II Patients. Cureus, 14(4), e23820. https://doi.org/10.7759/cureus.23820
Thomas, D., McDonald, V. M., Pavord, I. D., & Gibson, P. G. (2022). Asthma remission: what is it and how can it be achieved? Eur Respir J, 60(5). https://doi.org/10.1183/13993003.02583-2021
Wen, L., Zhong, W., Chai, Y., Zhong, Q., Gao, J., Guan, L., Huaiquan, L., Haiyang, Y., Qingxue, W., & Changfu, Y. (2020). Association of metformin use with asthma exacerbation in patients with concurrent asthma and diabetes: a systematic review and meta-analysis of observational studies. Canadian Respiratory Journal, 2020.
Wu, T. D. (2020). Diabetes and glycemic dysfunction in asthma. The Journal of Allergy and Clinical Immunology: In Practice, 8(10), 3416-3417.
Wu, T. D. (2021). Diabetes, insulin resistance, and asthma: a review of potential links. Curr Opin Pulm Med, 27(1), 29-36. https://doi.org/10.1097/mcp.0000000000000738
