title: Effect of intranasal steroids on glucose and hemoglobin A1c levels in diabetic patients.
abstract: BACKGROUND
  Intranasal steroids are widely used for the treatment of inflammatory diseases of the nose and sinuses such as rhinosinusitis, allergic rhinitis, and nonallergic rhinitis. Along with the general otherwise healthy population, many diabetic patients use intranasal  steroids as well. This study was designed to evaluate the adverse effects of long-term treatment with intranasal corticosteroid preparations in diabetic patients.
  
  
  METHODS
  The study group included all diabetic patients treated with intranasal steroids for at least 3 months  at primary care clinics in Clalit Health Services Central District in Israel in 2002-2007. The central database had been reviewed for demographic data, medical history, medications, and laboratory test results.
  
  
  RESULTS
  A total of 1768 diabetic patients were treated  with topical nasal steroid sprays during the study period. Data on hemoglobin A1c (HbA1c) levels both before and during steroid treatment was available for 245 patients, and data on fasting serum glucose levels at both time points was available for 163 patients. On statistical analysis, there  was no change in either measure from baseline to 3 months after starting treatment (p = 0.104 and p = 0.101, respectively). Treatment with triamcinolone acetonide was associated with a significantly greater increase in fasting serum glucose levels than other preparations (p = 0.006).
  
  
  CONCLUSIONS
  Intranasal corticosteroids seem to have no adverse effects on HbA1c and serum glucose levels in diabetic patients. Their long-term use appears to be safe, provided that the patients are carefully monitored, especially those receiving triamcinolone acetonide.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Rabin Medical Center, Petach Tikva and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. avirammi@bezeqint.net
authors.forename: Aviram
authors.initials: A
authors.lastname: Mizrachi
authors.forename: Gideon
authors.initials: G
authors.lastname: Bachar
authors.forename: Eitan
authors.initials: E
authors.lastname: Yaniv
authors.forename: Tuvia
authors.initials: T
authors.lastname: Hadar
authors.forename: Shlomo
authors.initials: S
authors.lastname: Vinker
mesh_terms: D000281:Administration, Intranasal; D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage* / Q000009:adverse effects; D001786:Blood Glucose / Q000032:analysis*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood*; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage* / Q000009:adverse effects; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D014222:Triamcinolone Acetonide / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D000893:Anti-Inflammatory Agents; D001786:Blood Glucose; D005938:Glucocorticoids; D006442:Glycated Hemoglobin; D014222:Triamcinolone Acetonide; C517652:hemoglobin A1c protein, human