High dose inhaled corticosteroids and dose dependent loss of diabetic control

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Abstract
We report a case of loss of diabetic control in a patient given high doses of inhaled fluticasone propionate for asthma. A 67 year old man who had had asthma for 10 years was referred for respiratory assessment. He had had non-insulin dependent diabetes mellitus for 40 years and was taking glibenclamide 5 mg and metformin 1700 mg daily. Glycaemic control was monitored every six weeks in an outpatient clinic using the percentage of glycated haemoglobin (haemoglobin A1c) (Corning-Drew Glycomat low pressure chromatography system).1 The normal range is <6% and the within batch coefficient of variation is 2.6% and 1.5% for concentrations of 7% and 10% respectively. …