Analysis of prevalence and prognosis of type 2 diabetes mellitus in patients with acute exacerbation of COPD

Abstract

Background For 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. Methods Inpatients 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. Results Of 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. Conclusions AECOPD 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.

Characteristics of patients referred to Canary Island pneumology outpatient services for chronic obstructive pulmonary disease: the EPOCan study

“…A national study performed in 129 hospitals throughout the Spanish territory, with more than 5000 patients included, analysed the characteristics of patients admitted for COPD Figueira-Gonçalves et al BMC Research Notes (2022) 15:36 exacerbation and evidenced a prevalence of active smoking, T2DM, and heart disease of 30, 26, and 30%, respectively, clearly below the prevalence detected in our study (37,40, 43%, respectively) [37]. All these factors can impact on the clinical progress of these patients in hospital [6,38,39]. However, conclusions from our sample should be drawn with caution as there may be a survival bias.…”

Statins Associated with Better Long-Term Outcomes in Aged Hospitalized Patients with COPD: A Real-World Experience from Pay-for-Performance Program

“…The prevalence of cardiovascular diseases in patients with COPD varies between 14% and 33% [30], and our cohort falls within this range. The prevalence of DM in patients with COPD varies from 9% to 30% depending on ethnicity and experimental design [31][32][33][34]; however, few studies have addressed DM prevalence in aged patients with COPD. We found DM prevalence was 56.4% in this cohort is higher than in previous studies [31][32][33][34].…”

“…The prevalence of DM in patients with COPD varies from 9% to 30% depending on ethnicity and experimental design [31][32][33][34]; however, few studies have addressed DM prevalence in aged patients with COPD. We found DM prevalence was 56.4% in this cohort is higher than in previous studies [31][32][33][34]. This discrepancy may be due to several factors, including the cohort's older median age (80; IQR: 70-87), increased severity of COPD (65.2% was Group C, and 34.8% was Group D) according to the GOLD classification [3], and requirement for the intensive followed-up due to the regulation of P-4-P program according to the guidance from National Health Insurance Program.…”

Procalcitonin kinetics to guide sequential invasive-noninvasive mechanical ventilation weaning in patients with acute exacerbation of chronic obstructive pulmonary disease and respiratory failure: procalcitonin’s adjunct role

“…In view of the fact that long-term use of invasive ventilator support measures could aggravate pulmonary infection, and lengthen the ventilator's standby time, which in consequence would increase the probability of ventilator dependence and other risks, it is of great concern clinically to make every effort to minimize the time of invasive ventilator support [33]. At present, the sequential invasive-noninvasive respirator-assisted ventilation has already been developed as the primary approach for treating patients with AECOPD complicated with ARF [34,35]. In the past, the time point of conversion between invasive and noninvasive ventilator support measures was mainly decided by the doctors based on their clinical experience, which, however, is still lacks of quantitative parameters to support such a decision due to the differences among individuals.…”