Asthma Watch

Pharmacy TimesJanuary 2011 Aging Population
Volume 77
Issue 1

Inhalers Linked to Diabetes in Asthma

Patients Patients with asthma and chronic obstructive pulmonary disease (COPD) who use inhaled corticosteroids are more likely to develop diabetes or have their diabetes progress significantly, according to new research published in the American Journal of Preventive Medicine.

The study included 380,000 respiratory patients. Researchers identified a 34% increase in the rate of new diabetes diagnoses among those who used inhalers. Among patients who used inhalers at the highest dose, they observed a 64% increase in diabetes onset and a 54% increase in disease progression.

Results showed that more than 30,000 of the study’s participants were diagnosed with diabetes within 5 years of inhaler treatment. The researchers also noted that diabetes worsened for the more than 2000 patients who had been diagnosed with the disease before using an inhaler.

The researchers stated that although inhalers are only intended for patients with the most severe symptoms of COPD, approximately 70% of patients with the condition are prescribed an inhaler. Given the results of this trial, prescribers should carefully weigh the benefits and risks of inhaler use—especially for patients with a high risk of developing diabetes.

Parental Stress is a Factor in Childhood Asthma

When combined with pollutants in the environment, stressed parents can have an impact on a child’s risk of developing childhood asthma, a new study suggests. The study, published in the Proceedings of the National Academy of Sciences, included 2497 Californian children aged 5 to 9 years. The participants had no prior history of asthma or wheezing. The children were followed for 3 years to determine whether or not they developed asthma within the trial period.

Researchers had parents fill out a questionnaire measuring their stress levels. The questionnaire included questions asking the mother to gauge how much control she had in her life, as well as how well she was able to deal with problems. The researchers also collected data on each child’s exposure to external pollutants, such as car exhaust, and exposure to tobacco smoke before birth.

The results showed that stress alone did not increase the risk for developing asthma, but stress combined with exposure to environmental pollutants and smoke before birth did increase asthma risk more than exposure to smoke and exhaust but not stress.

Researchers also suggested that the combination of traffic pollution, secondhand smoke, and stress are more common in low income areas, which may be a key to explaining why asthma affects more children who live in these areas. PT

Infants on Antibiotics Have Higher Asthma Risk

Infants who receive antibiotics within the first 6 months of life have an increased risk of developing asthma by the time they reach the age of 6, according to a study conducted by researchers at the Yale School of Public Health and published in the American Journal of Epidemiology.

The cohort study followed 1401 children and collected data from before they were born up until they were 6 years old. The results showed that children who were introduced to antibiotics before they were 6 months old were 53% more likely to develop asthma and allergies than children who did not take antibiotics.

Although earlier studies have suggested a link between antibiotics and asthma, they were less conclusive. In many cases, the medication was used to treat respiratory infections, which could be an early sign of asthma. To rule out this possibility, the Yale study excluded infants who were treated for respiratory infections with antibiotics.

Researchers concluded that antibiotics also increased the risk of asthma in children without respiratory tract infections. The adverse effects of antibiotics were strongest among children with no family history of asthma. The study results may warrant discussions between pharmacists and parents about the risks of antibiotic use in infants younger than 6 months.

Fast Fact: Annual expenditures for health and lost productivity due to asthma are estimated at more than $20 billion, according to the National Heart, Lung and Blood Institute.

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