Youth with Diabetes More Likely to Have Asthma

PASADENA Calif. – Children and young adults with diabetes are more likely to have asthma which may affect their ability to manage their diabetes. It may be more challenging for youth with asthma to maintain good glycemic control especially if their asthma is left untreated, according to a new study from the SEARCH Study Group (pdf), published online in Pediatrics.

The SEARCH for Diabetes in Youth Study is a large study of youth diagnosed with diabetes before the age of 20 from six clinical centers in California, Colorado, Hawaii, Ohio, South Carolina, and Washington.

Maintaining good blood sugar (glycemic) prevents or delays the onset of diabetic complications in people with diabetes, including children and young adults, but few studies have examined the association between glycemic control and asthma in youth with diabetes. This study examined the relationship between asthma and glycemic control in a racially and ethnically diverse group of 1,994 children and young adults aged 3 through 21 years with diabetes from across the United States. Researchers found the prevalence of asthma among all youth with diabetes was 11 percent, slightly higher than the general population. The prevalence of asthma was 10 percent among youth with type 1 diabetes and 16 percent among youth with type 2 diabetes. According to a previous Centers for Disease Control and Prevention report, nearly 9 percent of all children and young adults in the United States had asthma. Among youth with type 1 diabetes, those with asthma were more likely to have higher hemoglobin A1C, indicating poorer glycemic control.

It is important for parents and health care providers providing care for children and adolescents with type 1 diabetes to recognize and treat symptoms of asthma, said study lead-author Mary Helen Black, PhD, of the Kaiser Permanente Southern California Department of Research & Evaluation.

Researchers also found that a higher percentage of children with asthma and diabetes who are not taking any prescription medications for their asthma were more likely to have poor glycemic control and therefore had a harder time managing their diabetes. Treating asthma with leukotriene modifiers alone or in combination with rescue inhalers was associated with better glycemic control. In fact, 72 percent of these youth receiving these treatments had good glycemic control.

Among children and young adults with type 1 diabetes, those with asthma were also more likely to be overweight or obese. Researchers found 43 percent of youth with asthma were overweight or obese compared to 32 percent of those without asthma. Although these complex conditions have been on the rise since the 1990’s, the relationship between asthma, diabetes, and obesity is not well understood.

SEARCH is funded by the Centers for Disease Control and Prevention and the National Institute of Diabetes and Digestive and Kidney Diseases.

Other study authors included: Jean M. Lawrence, ScD, MPH, MSSA, from the Kaiser Permanente Southern California Department of Research & Evaluation in Pasadena, Calif; Andrea M. Anderson, MS, from the Department of Biostatistical Sciences, Wake Forest University School of Medicine, Winston-Salem, N.C.; Ronny Bell, PhD, from the Department of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, N.C.; Dana Dabelea, MD, PhD, from the Department of Epidemiology, Colorado School of Public Health, University of Colorado at Denver; Catherine Pihoker, MD, from the Department of Endocrinology, CHRMC, University of Washington, Pediatrics, Seattle, WA; Sharon Saydah, PhD, from the Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA; Michael Seid, PhD, from the Division of Pulmonary Medicine and Health Policy and Clinical Effectiveness, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH; Debra Standiford, RN, MSN, CNP, from the Division of Endocrinology, Cincinnati Children’s Hospital, Cincinnati; Beth Waitzfelder, PhD, from the Kaiser Permanente Center for Health Research Hawaii, Pacific Research Institute, Honolulu, HI; Santica Marcovina, PhD, ScD, from the Department of Medicine, University of Washington, Seattle, WA.

About the Kaiser Permanente Department of Research and Evaluation
The Department of Research & Evaluation (R & E) conducts high quality, innovative research into disease etiology, prevention, treatment and care delivery. Investigators conduct epidemiology, health sciences, and behavioral research as well as clinical trials. Areas of interest include diabetes and obesity, cancer, HIV/AIDS, cardiovascular disease, aging and cognition, pregnancy outcomes, women’s and children’s health, quality and safety, and pharmacoepidemiology. Located in Pasadena, Calif., the department focuses on translating research to practice quickly to benefit the health and lives of Kaiser Permanente Southern California members and the general population. Visit
http://www.kp.org/research/.

About Kaiser Permanente
Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America’s leading health care providers and not-for-profit health plans. Founded in 1945, our mission is to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. We currently serve 8.8 million members in nine states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal physicians, specialists and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the art care delivery and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health. For more information, go to: http://www.kp.org/newscenter/.