PURPOSE OF THE STUDY.
To estimate the prevalence of asthma among children with types 1 and 2 diabetes and examine associations between asthma and glycemic control.
Children diagnosed with type 1 (N = 1683) and type 2 (N = 311) diabetes from 2002 to 2005 as part of the SEARCH for Diabetes in Youth study.
Asthma status and medications were determined from medical records and self-administered questionnaires, and glycemic control was assessed from hemoglobin A1c measured during study visits.
The prevalence of asthma in all children with diabetes was 10.9% (95% confidence interval [CI], 9.6%–12.3%). The prevalence was 10% (95% CI, 8.6%–11.4%) among children with type 1 and 16.1% (95% CI, 12.0%–20.2%) among children with type 2 diabetes and differed by race/ethnicity. Among children with type 1 diabetes, higher mean A1c levels were observed in asthmatics versus nonasthmatics after adjustment for age, gender, race/ethnicity, and BMI (7.77% vs 7.49%, P = .034). Youth with asthma were more likely to have poor glycemic control, particularly those with type 1 diabetes whose asthma was not treated with routine pharmacotherapy.
The prevalence of asthma may be elevated in children with diabetes relative to the general US population. In children with type 1 diabetes, asthma is associated with poor glycemic control, especially if asthma is not treated with antiinflammatory medications.
This study further explores the complex relationships between systemic inflammatory diseases including obesity and both asthma and diabetes. The association between type 2 diabetes and asthma is not surprising as a high proportion of youth were overweight or obese (90.6%) and the linkage between asthma and increased BMI is well described in many studies. It is interesting to note that children whose asthma was treated with leukotriene modifiers, alone or in combination with inhaled corticosteroids or rescue inhalers, had the lowest prevalence of poor glycemic control; in fact, 72% had good glycemic control. The authors speculate that this could be because leukotriene synthesis or receptor blockers may help reduce the systemic inflammation present in both obesity and diabetes as well the direct effect on ameliorating airway inflammation.
- Copyright © 2012 by the American Academy of Pediatrics