Abstract
BackgroundFor patients with acute exacerbation of COPD (AECOPD), type 2 diabetes mellitus (T2DM) as comorbidity have poor outcomes. However, data on the impact of previously diagnosed and new- diagnosed T2DM in such a patient population is lacking.MethodsInpatients diagnosed with AECOPD in the department of Pulmonary and Critical Care Medicine of The First Hospital of China Medical University during 2011–2017 were enrolled. Data on demography, prevalence of type 2 DM, other comorbidities, hospital stays and laboratory tests (including arterial partial pressure of oxygen [PaO2]) results were recorded. Results were compared with AECOPD patients having previously diagnosed and new-diagnosed type 2 diabetes. Markers associated with development of type 2 DM and the prognosis of AECOPD patients were identified.ResultsOf the 196 patients enrolled in this study, the overall prevalence of T2DM was 26%. The PaO2 in the newly diagnosed T2DM group was considerably lower versus non-diabetic group. The T2DM group had a longer hospital stay and higher troponin level versus the non-diabetic group. AECOPD patients with T2DM were found to be correlated with hypertension. Age, need for assisted ventilation, increased troponin, and elevated fasting blood glucose on admission were risk factors for death in hospitalized AECOPD patients.ConclusionsAECOPD patients had a higher prevalence of T2DM than the general population; T2DM comorbidity caused lower PaO2, longer hospital stays, and increased troponin. Poor blood glucose control may increase the risk of death in AECOPD patients.
Highlights
For patients with acute exacerbation of Chronic Obstructive Pulmonary Disease (COPD) (AECOPD), type 2 diabetes mellitus (T2DM) as comorbidity have poor outcomes
Several studies explored the incidence and prognosis of D.M. among acute exacerbation of COPD (AECOPD) patients; the diagnosis of D.M. among patients hospitalized for AECOPD was about 22% in Australia [10], 18% in Switzerland [11], 22% in Taipei [12], and a high of 40% in India [13]
An investigation conducted in Finland, focusing on AECOPD among patients using inhaled beta-2-adrenergic bronchodilators and oral glucocorticoid, the prevalence of hyperglycemia was found to reach up to 82% [14]
Summary
For patients with acute exacerbation of COPD (AECOPD), type 2 diabetes mellitus (T2DM) as comorbidity have poor outcomes. Acute exacerbation is the leading cause of hospitalization and mortality among COPD patients. An investigation conducted in Finland, focusing on AECOPD among patients using inhaled beta-2-adrenergic bronchodilators and oral glucocorticoid, the prevalence of hyperglycemia was found to reach up to 82% [14]. These data were comparatively much higher than those in the general population [15, 16]. Comorbidity with hyperglycemia may cause even worse prognosis for AECOPD; the risk of hospital stay and death increases by 7–15% for each 1 mmol/L increment in blood glucose concentration [17, 18]. Little effort has been made to recognize the incidence and effect of T2DM among AECOPD patients, or the differences between previously diagnosed and newly diagnosed T2DM in Mainland China
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