COPD Linked to Diabetes and Post-Diabetes Pneumonia

Patients with chronic obstructive pulmonary disease, particularly with exacerbations, have an increased risk for diabetes development.

Patients with chronic obstructive pulmonary disease (COPD) have an increased risk of developing diabetes or post-diabetes pneumonia, as well as an increased risk for higher mortality compared with individuals without COPD, according to a study published by PLOS ONE.

Researchers identified 4671 patients with a new diagnosis of COPD with exacerbations (COPDe), and 9342 adults with a new diagnosis of COPD without exacerbations (COPD) and matched them by age and sex with 18,684 randomly selected adults without COPD.

During the follow-up period, patients with COPD and COPDe had a higher incidence of diabetes (4.1 and 7.4 per 1000 person-years, respectively) vs 3.4 per 1000 person-years in patients without COPD (P <.0001). Hazard ratios (HR) for the development of diabetes in patients with COPD were higher in patients with exacerbations at 2.18 (95% CI, 1.88-2.52) than in patients without exacerbations at 1.09 (95% CI, 1.02-1.17). 

Compared with individuals without COPD, patients with COPDe had higher rates of intensive care unit (ICU) admissions (odds ratio [OR], 1.32; 95% CI 1.26-1.39), development of post-diabetes pneumonia (OR, 3.28; 95% CI, 3.13-3.43), and a higher mortality rate (OR, 2.06; 95% CI, 1.88-2.25).

The investigators concluded that patients with and without COPD exacerbations are at a significantly higher risk for diabetes, longer hospital stays, ICU admissions, increased medical expenditures, and mortality compared with individuals without COPD. Strategies for prevention and intervention are needed for diabetes and post-diabetes outcomes in patients with COPD. 

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Lin CS, Liu CC, Yeh CC, et al.  Diabetes risks and outcomes in chronic obstructive pulmonary disease patients: two nationwide population-based retrospective cohort studies[published online August 16, 2017].  PLoS One. doi:10.1371/journal.pone.0181815