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Inhaled Steroids May Increase Diabetes Risk

Study: Steroid Inhalers for Breathing Problems May Slightly Increase Risk of Type 2 Diabetes

A Small Risk Can Still Mean a Big Problem

“This is a modest increase, but it’s not something to sneeze at because type 2 diabetes is such an expensive problem,” says Elizabeth Kern, MD, director of the diabetes program at National Jewish Health in Denver, a hospital that specializes in the treatment of lung disease.

Kern says the findings of this investigation were much anticipated and somewhat controversial among doctors who treat respiratory problems since previous, smaller studies had failed to find an increased risk of diabetes in patients treated with inhaled corticosteroids.

“His point, which I think is correct, is that those trials are really underpowered to see the risk,” she says.

On the other hand, Kern’s colleague, Rohit Katial, MD, a professor of medicine at National Jewish Health, said that despite the study’s large size, he thought it still had important deficiencies, the most important being that researchers had no information about the numbers of people who might have been overweight or obese, which is a significant risk factor for both diabetes and breathing problems.

“For the people on higher doses of medications, was their BMI [body mass index] higher? We don’t know, that information wasn’t in the paper,” Katial says.

Still, he noted that the study was a reminder that it was important for doctors to aim for the lowest possible doses of corticosteroids needed to treat breathing problems and to open a dialogue about the risks with their patients who already have diabetes.

“We tell them to keep an eye on their sugars,” he says.

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