Untreated Asthma Worsens Diabetes in Children – or is this Nonsense?

A new study that suggests diabetic children with untreated asthma have a harder time controlling their blood sugar levels has run into criticism.  More research is needed before the claim can be accepted, due to the limitations of the analysis, says an expert.

Around 215,000 American youngsters have diabetes, mostly Type 1, which is caused by an autoimmune response in the body, which is not yet fully understood.  The response destroys beta cells in the pancreas, which manufacture insulin, the hormone that allows us to absorb and store sugars from our food.  Without these cells, the youngsters have to have insulin injections and monitor their blood sugar levels carefully to stay healthy.

A small proportion of children and young people now have Type 2 diabetes, in which the pancreas may still be producing insulin, but the body’s tissues have lost their ability to respond to it.  This Type is associated with obesity and poor lifestyle choices but does not usually require insulin injections.

Both Types of diabetes carry the potential for serious health complications if blood sugar levels are not controlled adequately.

Now a new study published in the October 2011 issue of the journal Pediatrics says researchers found diabetic children with untreated asthma were less able to control their blood sugar.  The scientists studied the cases of 2,011 diabetic children between 2002 and 2005, 1,700 of whom were Type 1 diabetics and 311 Type 2 diabetics.  Ten percent of the children with Type 1 and just over 16% of the Type 2 diabetics were also asthmatic.

Asthma affects 17 million people in the US, including seven million children, and is on the increase, especially in children.  It is a common respiratory disorder involving chronic or long-term inflammation of the airways, which can lead to persistent coughing, breathlessness and wheezing.  Typically, an asthmatic attack is triggered by something in the air, such as a high pollen count, fungal spores at some seasons or other allergens, or by high levels of stress or emotional upset. Asthmatics are generally treated with corticosteroids delivered through a hand-held inhaler, which the sufferer should always carry with them.

In the new study led by Dr Mary Black of Kaiser Permanente,California, researchers found a link between untreated asthma and poor control of blood glucose.  They found children with Type 1 diabetes and asthma averaged blood glucose levels a whopping three points higher than those without and was 37% likelier to have poor blood sugar control.  However, children treated with Leukotriene for their asthma had better blood sugar control and levels.

No significant correlation was found between asthma and Type 2 diabetes, but the scientists felt this was due to the smaller number of Type 2 subjects in the study.

“Among youths with Type 1 diabetes, asthma is associated with poor glycemic control, especially if asthma is untreated,” the scientists reported.

However, Dr. Juan Celedon, chief of service of the division of pediatric pulmonology, allergy, and immunology at Pittsburgh’s Children’s Hospital, suggested the team had misunderstood the findings.  He felt the children with untreated asthma were more likely to have poor blood sugar control because they were poorer children who had less access to good healthcare. “My concern is that there is confounding by socioeconomic status and access to health care,” he said.

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