Seretide Accuhaler is the brand name while the name of the medicine that it delivers per dose is Salmeterol 50mcg and Fluticasone 500mcg. Since the drugs are inhaled, very little reaches the blood though there is a small risk of aggravating diabetes when steroids such as Fluticasone are used. Irrespective of its side effects, the patient definitely needs treatment for asthma. Therefore, one has to accept the small risk. I presume that the patient was on some other (oral) medication earlier and was not adequately responding. Diabetes is a progressive disease and hence goes on becoming worse requiring more medication. I suggest that the anti-diabetic treatment be reviewed instead of changing asthma medication.