Epidemiology

Asthma tied to poorer diabetes control in kids

NEW YORK (Reuters Health) – Kids with diabetes may have a higher-than-average rate of asthma, and those with both conditions seem to have a tougher time keeping their blood sugar under control, a study in Pediatrics this week suggests.

Among 2,000 3- to 21-year-olds with diabetes, 11% had asthma — higher than the roughly 9% rate among children and young adults in the U.S.

The difference was bigger when the researchers looked at the 311 young people with type 2 diabetes.

In that group, 16% had asthma, compared with 10% of those with type 1 diabetes.

In this study, kids with type 1 diabetes and asthma were more likely to have a hemoglobin A1C level of more than 9.5%, compared to their peers who were asthma-free: 15.5%, versus 9%.

The reasons for the findings, which were published online yesterday, are not completely clear.

But the higher rate of asthma among young people with type 2 diabetes suggests a role for obesity, according to lead researcher Dr. Mary Helen Black of Kaiser Permanente Southern California.

”It’s pretty well-established that there’s an obesity-asthma connection,” Dr. Black told Reuters Health in an interview.

As for why young people with type 1 diabetes and asthma had poorer blood sugar control, one possibility is that there is a ”real biological connection,” Dr. Black said.

Research has found that people with poorly controlled diabetes are more likely to show dips in lung function over time than those with well-controlled diabetes. But the reasons for that are unknown.

On the other hand, Dr. Black said, it may simply be tougher for kids with type 1 diabetes to control their blood sugar when they have another chronic health problem.

”It can be incredibly challenging to manage both conditions,” Dr. Black said.

The researchers did find that when kids with both diseases were on asthma medication, their blood sugar control was better.

In particular, poor blood sugar control was seen in less than 5% of those taking leukotriene modifiers, vs about 30% of type 1 diabetics who were not on medication for their asthma.

The researchers are not sure if that means there’s an effect of the asthma drugs themselves. It may just be that kids with better-controlled asthma are also more likely to have well-controlled diabetes, according to Dr. Black.

She said the bottom line for doctors and parents is to be aware that kids with diabetes may have a somewhat higher rate of asthma — and that those with both may have more trouble with blood sugar control.

Pediatrics 2011 Oct.

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Publicerad: |2011-09-27|