Prevalence of self-reported asthma in type 1 diabetes children and its associated predictors
Main Article Content
Keywords
asthma, asthma symptoms, type 1 diabetes, children, prevalence, predictors
Abstract
Background: Asthma is considered one of the most common and serious noncommunicable diseases, with high morbidity and mortality rates in both children and adults.
Objectives: To estimate the frequency and to determine the associated factors of self-reported asthma among children diagnosed with type 1 diabetes.
Methods: A cross-sectional study design was employed, and 175 subjects having type 1 diabetes for more than 1 year were included from the pediatrics endocrine clinic. Validated questionnaires from the International Study of Asthma and Allergies in Childhood (ISAAC) were used for data collection. Statistical analysis was performed using SPSS version 23.0.
Results: The study included 175 participants (48% boys, 52% girls) with a mean age of 10.9 ± 3.76 years. The majority were of high socioeconomic status, that is, with a monthly family income >15,000 Saudi Riyal (SR) . Notably, 78 participants (44.6%) were diagnosed with type 1 diabetes (2–5 years’ duration, and the average age at diagnosis was 7.4 ± 3.27 years). Hospital admissions due to diabetes in the past year were reported in 101 (57.7%) patients. Moreover, 143 (81.7%) participants reported hyperglycemic symptoms, while 125 (71.4%) experienced hypoglycemic symptoms. About 36 (20.6%) participants had self-reported asthma, with wheezing reported in 46 (26.3%) participants. Other sociodemographic and diabetes factors showed no significant associations. The prevalence of self-reported asthma was noted in 36 children with type 1 diabetes (20.6%). The presence of a family history of asthma was the only significant variable associated with self-reported asthma in children with type 1 diabetes (p<0.001). The odds of developing asthma increased by almost 11 times among children with type 1 diabetes who had a positive family history of asthma (p=0.002). Middle-income status also showed increased odds of risk for developing asthma by 4.4 times, but it did not reach the level of statistical significance (p=0.21).
Conclusion: A higher prevalence of self-reported asthma was found among children with type 1 diabetes. Those with a family history of asthma may be considered for screening and educational programs.
References
2 Porsbjerg C, Melén E, Lehtimäki L, Shaw D. Asthma. Lancet. 2023;401(10379):858–873. 10.1016/S0140-6736(22)02125-0
3 Uphoff EP, Bird PK, Antó JM, Basterrechea M, Von Berg A, Bergström A, et al. Variations in the prevalence of childhood asthma and wheeze in MeDALL cohorts in Europe. ERJ Open Res. 2017;3(3):150–2016. 10.1183/23120541.00150-2016
4 Woodruff PG, Khashayar R, Lazarus SC, Janson S, Avila P, Boushey HA, et al. Relationship between airway inflammation, hyperresponsiveness, and obstruction in asthma. J Allergy Clin Immunol. 2001;108(5):753–758. 10.1067/mai.2001.119411
5 Mukherjee M, Nair P. Autoimmune responses in severe asthma. Allergy Asthma Immunol Res. 2018;10(5):428–447. 10.4168/aair.2018.10.5.42
6 Mobasseri M, Shirmohammadi M, Amiri T, Vahed N, Fard HH, Ghojazadeh M. Prevalence and incidence of type 1 diabetes in the world: A systematic review and meta-analysis. Health Promot Perspect. 2020;10(2):98–115. 10.34172/hpp.2020.18
7 Chiang JL, Maahs DM, Garvey KC, Hood KK, Laffel LM, Weinzimer SA, et al. Type 1 diabetes in children and adolescents: A position statement by the American Diabetes Association. Diabetes Care. 2018;41(9):2026–2044. 10.2337/dci18-0023
8 Tatovic D, Marwaha A, Taylor P, Hanna SJ, Carter K, Cheung WY, et al. Ustekinumab for type 1 diabetes in adolescents: A multicenter, double-blind, randomized phase 2 trial. Nat Med. 2024;30(9):2657–2666. 10.1038/s41591-024-03115-2
9 Cardwell CR, Shields MD, Carson DJ, Patterson CC. A meta-analysis of the association between childhood type 1 diabetes and atopic disease. Diabetes Care. 2003;26(9):2568–2574. 10.2337/diacare.26.9.2568
10 Smew AI, Lundholm C, Sävendahl L, Lichtenstein P, Almqvist C. Familial coaggregation of asthma and type 1 diabetes in children. JAMA Netw Open. 2020;3(3):e200834. 10.1001/jamanetworkopen.2020.0834
11 Metsälä J, Lundqvist A, Virta LJ, Kaila M, Gissler M, Virtanen SM, et al. The association between asthma and type 1 diabetes: A paediatric case-cohort study in Finland, years 1981–2009. Int J Epidemiol. 2018;47(2):409–416. 10.1093/ije/dyx245
12 Pearce N, Aït-Khaled N, Beasley R, Mallol J, Keil U, Mitchell E, et al. Worldwide trends in the prevalence of asthma symptoms: Phase III of the International Study of Asthma and Allergies in Childhood (ISAAC). Thorax. 2007;62(9):758–766. 10.1136/thx.2006.070169
13 Klamt S, Vogel M, Kapellen TM, Hiemisch A, Prenzel F, Zachariae S, et al. Association between IgE-mediated allergies and diabetes mellitus type 1 in children and adolescents. Pediatr Diabetes. 2015;16(7):493–503. 10.1111/pedi.12298
14 Kero J, Gissler M, Hemminki E, Isolauri E. Could TH1 and TH2 diseases coexist? Evaluation of asthma incidence in children with coeliac disease, type 1 diabetes, or rheumatoid arthritis: A register study. J Allergy Clin Immunol. 2001;108(5):781–783. 10.1067/mai.2001.119557
15 Hsiao YT, Cheng WC, Liao WC, Lin CL, Shen TC, Chen WC, et al. Type 1 diabetes and increased risk of subsequent asthma: A nationwide population-based cohort study. Medicine (Baltimore). 2015;94(36):e1466. 10.1097/md.0000000000001466
16 Burr ML, Butland BK, King S, Vaughan-Williams E. Changes in asthma prevalence: Two surveys 15 years apart. Arch Dis Child. 1989;64(10):1452–1456. 10.1136/adc.64.10.1452
17 Kamei JM, Maués RD, Oliveira Silva G, Machado AH, Hoshino EM, Bacchiega FM, et al. Prevalence of asthma in people with type 1 diabetes mellitus: A scoping review. Allergy Asthma Clin Immunol. 2024;20(1):12. 10.1186/s13223-024-00869-9
