Inhaled Corticosteroids Linked to Diabetes Risks - What About Our EE Kids?

There are few treatment options for our EE children.  They can either be treated through diet, inhaled or swallowed corticosteroids, or both.  In some cases, these inhaled steroids are the only thing that keeps our children in remission.  They have tried food elimination or elemental diets, but have failed until the inhaled steroids that our children swallow were added to the mix.  Although it doesn't cure them, it may allow them to start trialing foods, or eating foods they were unable to before.  Even though we know there may be side effects, they were not supposed to be as harmful as systemic steroids.  The lesser of two evils, and we want our children to feel better and heal.

So when I stumbled across the article Inhalers Linked to Higher Odds of Diabetes in Asthma, COPD Patients I was less than enthused.  It has long been known that oral systemic corticosteroids such as prednisone can cause diabetes, but this is the first time there has been a link to inhaled steroids, said Samy Suissa, director of the Centre for Clinical Epidemiology at the Lady Davis Institute for Medical Research of the Jewish General Hospital. 


In a study of nearly 400,000 people in Quebec, the researchers found that inhaler use was associated with a 34% increase of new diabetes diagnosis and diabetes progression.  The study observed that 30,000 of their patients developed diabetes over 5 and 1/2 years of treatment, and patients that already had diabetes experienced a worsening of their disease. Samy Suissa reports their findings in the most recent issue of the American Journal of Preventive Medicine.  Based on their results, researchers from McGill University and the Lady Davis Research Institute at Jewish General Hospital in Montreal suggest patients should only be treated when there is a clear benefit.  What other choice do our children have?  Does the risk outweigh the benefit?  It seems that we are running the risk of adding just another diagnosis to our already multiple diagnosed children.  But again, I ask, what are the options?

At least in the report Dr. Weiss, who is also a clinical assistant professor at the NYU School of Medicine in New York City suggests that the concern should also be directed at the person's lifestyle, eating habits and other underlying causes of diabetes.  He concedes,  "Yes, we do know that steroids increase insulin resistance and that people treated with steroids require more aggressive diabetes management.  But if we don't generally take an approach that deals with the poor quality of food that people are routinely consuming, the incidence of both these diseases will continue to go up at a dramatic rate."

Does that make me feel better?  Not so sure.  My wish, as I'm sure is yours, is for one of these doctors/scientists to come up with a cure for our children so they don't have to take all this medication everyday, and they would enjoy a life WITH food and WITHOUT pain.

Biopsy after Food Introduction

After being an elemental (EO28Splash) only diet for 10 months, Andrew began eating food in late October.  As I had mentioned in a previous post, he started with bison, but soon had symptoms, so we eliminated it and began sweet potatoes.  He has since been introduced to peaches and broccoli as well.  We had to eliminate the broccoli after a week due symptoms.  The sweet potatoes and peaches have remained a constant, seemingly causing no symptoms.

He had his first biopsy after the food introduction on January 30.  The results, although not positive for EE (>15), were 11 eos per hpf.  This is elevated from his pre food introduction biopsy of less than 5 eos per hpf.  The scope was done only 2 weeks after stopping broccoli, so our doctor said that CHOP reccommends to stop the last food that caused symptoms, but not take out the other foods.  So at this time Andrew will continue with the sweet potato and peaches.  He was also allowed to begin another new food yesterday from the "A List" given to us from our doctor.  He chose one of his old favorites, grapefruit.  It was so wonderful watching his pure joy eating it for "dessert" last night.

That is our plan for the immediate future for Andrew.  However, as all of you with children with EE know, nothing with EE is ever uncomplicated.  As I had mentioned before, he began symptoms with the broccoli a week after beginning it.  One of the symptoms was a constant stomach ache.  This stomach ache has continued even though he has been off broccoli for about a month.  He has battled problems with constipation in the past and is on Mirolax daily, but when they took an abdominal X-ray at the hospital it was clear.  The GI feels that it may be functional stomach pain, but I'm just not convinced.  There is never a dull moment with these kids.   If anyone has any ideas I would love to hear them.

Well, here's to hoping grapefruit will be a successfull food!

A New Year

Wow, once again it has been quite a while since my last post.  In early October I was asked to sub for two weeks for a teacher that was 14 weeks pregnant.  She was put on modified bed rest for the duration of her pregnancy and was unable to return to school.  I agreed to continue teaching the class for the remainder of the school year.  Although I have been crazy busy and extremely tired, it has also been very rewarding.  It has reminded me of the reasons I entered into teaching all those years ago.  And, as an added bonus, I get to teach my son content and writing each day (in our school, third graders switch classes)...and he likes it, too!

So, between teaching and taking care of my two children with special needs of their own, my blog has taken a back seat.  This saddens me because topics constantly creep into my mind that I know will be perfect for this blog.  I am hoping that now that the holidays are over and I am becoming acclimated once again with teaching, things will calm down and I will have some time to devote to some posts once again. 

As for today, a bonus day here in the Carolinas, due to the day off because of the snow, I plan to use some of this time to start some posts...and maybe even finish one.

Happy Snow Day....And Happy New Year!