Abstract #1413249: Acute Exacerbations of Chronic Obstructive Pulmonary Disease and its Association with Glycaemic Control

Abstract

Hyperglycemia is associated with poor outcomes in patients with pneumonia, myocardial infarction, and stroke but the effect of hyperglycemia on outcomes during AECOPD has not been definitely established. This study was aimed to find out the relationship between the glycaemic status and AECOPD This real world, retrospective longitudinal study was carried out among 280 adults having T2DM with the co-morbidity of COPD who also visits OPD seeking consultation for AECOPD episodes. Study was carried on for a period of 2.5 years. The patients were divided into 3 Groups according to mean HbA1c status. (A<7%, B≥7% to ≤8% and C>8% to ≤9.5%). The follow up visits were scheduled once every 3 months, (extra OPD visits were encouraged for exacerbation of any respiratory symptom). 85 patients needed hospitalisation for episodes of AECOPD, out of which 26 patients needed admission in the ICU with 7 patients needing invasive ventilation. 3 patients out of these 7 died. Men weighed 89±24 kg, with a body mass index (BMI) of 31.5±9.1 kg/m2. Participants had a 65±43 pack-year smoking history. Highest percentage of AECOPD episodes (43%) were observed with Group A whereas group B it was 35% and Group C it was 40%. Exacerbations were characterised by increased dyspnoea (100%), wheeze (83%), chest tightness (72%) and cough (69%). Of the 85 patients needing hospitalisation, majority (84%) belonged to Group C (HbA1c >8%). This study showed that factors other than glycaemic control are also responsible for episodes of AECOPD in patients of T2DM, though a poor glycaemic control (Group C) has a greater risk of hospitalisation. Hence other factors like increasing age, longer duration of COPD, malnutrition, irregular inhalation therapy, etc. needs to be looked into details as aetiology, leading to episodes of AECOPD besides glycaemic control in patients of T2DM.