EFFECT OF INHALED CORTICOSTEROID ON BLOOD GLUCOSE AND HBA1C LEVELS IN PATIENTS OF ASTHMA AGED 3-12 YRS

Abstract

INTRODUCTION: Asthma is a major health concern globally. Asthma, the common chronic disease in children creates not only a myriad of physical, emotional and social problems for the child and the family but also a nancial burden on the family. Though many drugs are available for treatment of asthma, steroid therapy remains the mainstay of treatment and control of recurrent attacks and long-term outcome. The safest and most effective choice for this is inhaled corticosteroids. Adverse effects following prolonged use of systemic corticosteroids are well established on carbohydrate metabolism. Patients on moderate to severe doses of Inhaled corticosteroid (ICS) may have similar effects on carbohydrate metabolism when used for prolonged period. HbA1c levels indicate blood glucose levels concentration in the preceding 8-12 weeks. There is denite evidence of raised Plasma glucose levels with the use of ICS but very scanty literature studying the levels of HbA following use of ICS is available specially in pediatric age group.Some studies do not show signicant rise in plasma 1c glucose or HbA1c The present study was planned to see if there is any change in blood glucose and HbA1c in patients who were on prolonged use of ICS i.e. more than 4 months of moderate to high dose 200 µg to 800 µg and more of inhaled corticosteroid per day were included. RESULT : Correlation between HbA1c levels and duration of Budesonide used.It is seen that cases using budesonide for upto 6 months and upto 600 µmg per day and for less than 6 month had mean HbA1c levels of 5.24+0.80% and those using more than 600µgm per day and for more than 6 month had mean HbA1c level of 5.611+.38%. It is seen that as the dose and duration increase HbA1c level also increase. The difference was not statistically signicant.