This article is part of Pulmonology Advisor’s coverage of the CHEST Virtual 2020 meeting.

Patients with chronic obstructive pulmonary disease (COPD) who have higher levels of glycosylated hemoglobin (HbA1c) are at increased risk for hospital admission for acute exacerbations of COPD (AECOPD), according to research presented at the 2020 CHEST Annual Meeting, held virtually October 18 to 21.

Researchers conducted a retrospective cohort study of patients with COPD in a Florida health care system (N=1516); patients were classified into groups of incremental HbA1c levels: 5.1 to 6.0, 6.1 to 7.0, 7.1 to 8.0, 8.1 to 9.0, and 9.1 to 10.0. Patients were evaluated by rates of AECOPD, and a chi-square model was used to identify the association and incidence of diabetes and its effects on the frequency of acute exacerbations among patients.

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After patient assessment, 16.98% of patients with an HbA1c between 5.1 and 6.0 had COPD exacerbations. In addition, 18.87% of patients with an HbA1c between 6.1 and 7.0 had exacerbations, and 21.53% of patients with an HbA1c between 7.1 and 8.0 had exacerbations. There was a 1.18% decline in the frequency of exacerbations in patients with an HbA1c between 8.1 and 9.0, and there was a significant surge of 5.31% in the frequency of AECOPD in patients with an HbA1c between 9.1 and 10.0.

“Our results strongly implicate uncontrolled blood sugars as an influencing factor in the frequency of AECOPD,” concluded the study authors. “By far, an overall increase in frequency from 18.87% for HbA1c levels [between] 6.1 [and] 7.0 to 25.66% AECOPD admissions for an HbA1c level [between] 9.1 [and] 10.0 highlights the correlation.”


Srinivasan V, Sinyor B, Butt WS, at al. The effect of uncontrolled diabetes mellitus on frequency of acute exacerbation of COPD. Presented at: the CHEST Virtual Annual Meeting; October 18-21, 2020. Abstract 1728.

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