HbA1c Levels in Children with Persistent Asthma on Inhaled Corticoids: A Descriptive Cohort Study

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 longterm inhaled corticosteroids.