HbA1c Levels in Children with Persistent Asthma on Inhaled Corticoids: A Descriptive Cohort Study
Published: March 1, 2019 | DOI: https://doi.org/10.7860/JCDR/2019/40697.12727
Kaarthikeyani Sankaravadivelu, Padmasani Venkat Ramanan, Rajesh Balan
1. Postgraduate, Department of Paediatrics, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India.
2. Professor, Department of Paediatrics, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India.
3. Associate Professor, Department of Paediatrics, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India.
Correspondence
Dr. Rajesh Balan,
Plot No. 23, Brindavan Nagar Extension, 3rd street, Adambakkam, Chennai-600088, Tamil Nadu, India.
E-mail: b_drrajesh@yahoo.com
Introduction: Asthma is one of the most common chronic respiratory conditions in children. Inhaled corticoids have revolutionised the treatment of asthma but long-term inhaled and systemic corticoids have been shown to have an effect on glucose metabolism.
Aim: To compare the glycosylated haemoglobin (HbA1C) levels in children with asthma on Inhaled Corticosteroids (ICS) for less than 6 months with that of children on ICS for 1-6 months.
Materials and Methods: The study was a descriptive cohort study done in the Paediatric Asthma clinic in a tertiary care teaching hospital in Southern India. Authors enrolled 75 children aged 1-18 years with persistent asthma (GINA guidelines) on inhaled corticosteroids for six months or more (cases) and another 75 age-matched children on inhaled corticosteroids for 1-6 months (controls). The HbA1c levels in the two groups and its relationship with cumulative dose of ICS was analysed. Various clinical factors were compared using chi-square test. Mean HbA1c levels between the two groups were compared using Student’s t-test.
Results: Among the children studied, 7 (9.3%) of cases and none of controls had elevated HbA1C levels above 6%. The difference was statistically significant (p-value=0.0067). The Mean HbA1C level in cases was 5.27 and 5.07 in controls. The difference was statistically significant (p-value=0.007). There was an increase in HbA1c levels with increase in total cumulative dose of steroids (Coefficient of correlation 0.23).
Conclusion: HbA1c levels become significantly higher in children on inhaled corticosteroids for more than six months. Hence glycaemic status needs to be monitored in all children on long-term inhaled corticosteroids.
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