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While physicians were once hesitent to prescribe a daily dose of inhaled corticosteroids to control asthma, steroid inhalers have since become a top line therapy for preventing and controlling asthma(1,2). Many of the benefits from using steroids are due to a reduction in the body's immune response to viruses or bacteria (2,3). Most patients treated with steroids do not respond to a daily dose. Patients are more likely to have a successful outcome with continuous therapy, especially those with a previous history of steroid use (4). However, many patients with asthma who are taking a daily dose of steroid steroids need to be treated again or even at a higher dose in order to provide some control over their symptoms.Steroids, especially acesulfame-K, have the potential to lower serum levels of the enzyme glucagon-like peptide 1 (GLP-1) for prolonged periods of time. When combined with the inhaled corticosteroid, the combination of glucagon and steroids cause a decrease in the rate of digestion of glucagon (5). In an attempt to maintain adequate blood levels of GLP-1, steroid inhalers (i.e., inhalers with high levels of glucagon) are prescribed for short or prolonged periods of time. However, the use of acesulfame-K, which is a small peptide, can have many of the same effects on blood levels of glucagon as steroids. In certain patients, who may have hypophosphatemia, the administration of acesulfame-K has been associated with a worsening of symptoms, particularly with prolonged use (6). A few studies have suggested that some individuals who use acesulfame-K for prolonged periods may experience an increase in the risk for pulmonary hypertension (increased blood pressure in the middle of the chest (7) due to increased blood vessels in the lungs (8). The mechanism behind the increase in blood pressure may be due to the increased production of norepinephrine and epinephrine, which is a byproduct of glucagon synthesis.Steroids can also be used to treat other chronic conditions, such as asthma, multiple sclerosis, irritable bowel syndrome (IBS), cystic fibrosis, and chronic obstructive pulmonary disease (COPD), as well as for short term pain control (9-11). They are commonly used in patients with severe asthma for pain control, which improves on its own after an initial dose of inhalers but increases with continued use over a few days. They are also used in those with chronic bronchitis, which was once considered one of the most disabling conditions of life. The long-term benefits of using steroids haveSimilar articles: