Asthma more prevalent among youth with diabetes

Asthma may contribute to poor glycemic control in youth with diabetes, especially if the disease is left untreated, according to the results of a study published online September 26 in Pediatrics.

To estimate the prevalence of asthma among youth with types 1 and 2 diabetes and examine associations between asthma and glycemic control, investigators conducted a cross-sectional analysis of data from the SEARCH for Diabetes in Youth study. The study included a highly diverse population of children and adolescents ranging in age from 3 to 21 who were diagnosed with type 1 (n=1,683) and type 2 (n=311) diabetes from 2002 through 2005.

Among those 1,994 participants, 218 had asthma (10.9% [95% CI, 9.6%–12.3%]), including 168 youth who were diagnosed with type 1 diabetes (10.0% [95% CI, 8.6%–11.4%]) and 50 youth with type 2 diabetes (16.1% [95% CI, 12.0%–20.2%]). Youth with asthma were also more likely to have poor glycemic control (P=.025). Asthma was significantly associated with glycemic control among youth with type 1 diabetes but not among youth with type 2 diabetes. Among youth with type 1 diabetes, those with asthma were 1.37 times as likely to have poor glycemic control than good control (95% CI, 1.08–1.73) and 1.91 times as likely to have poor glycemic control than either intermediate or good control (95% CI, 1.21–3.02) compared with youth without asthma. In addition, those with asthma had higher mean A_1c levels than those without asthma, after adjusting for age, gender, race/ethnicity, and body mass index (BMI) (7.77% vs 7.49%; P=.034).

Among youth with type 1 diabetes and asthma, glycemic control was significantly associated with medication use (P=.045). Approximately one-third of youth who did not receive pharmacologic treatment, 17% treated with inhaled corticosteroids, and 14% treated with rescue inhalers had poor glycemic control. However, after adjusting for age, gender and race/ethnicity, youth with untreated asthma were at greater risk for poor glycemic control than those receiving pharmacotherapy.

The authors noted that specific asthma medications may decrease the systemic inflammation underlying the relationship between pulmonary function, BMI, and glycemic control in youth with diabetes, and add that further investigation of this effect is necessary for better understanding.