Effect of Hyperglycemia on Outcome of Acute Exacerbation of Chronic Obstructive Pulmonary Disease.

Abstract

COPD is a growing cause of morbidity and mortality worldwide, and will be the third leading cause of death by 2020. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) recently defined COPD as "Chronic Obstructive Pulmonary Disease (COPD) is a common, preventable and treatable disease that is characterized by persistent respiratory symptoms and airflow limitation that is due to airway and/or alveolar abnormalities usually caused by significant exposure to noxious particles or gases". [1] Hyperglycaemia is of interest as it is associated with poor outcomes from acute hospital admission for other conditions. Hyperglycemia associated with critical illness (also called stress hyperglycemia or stress diabetes) is a consequence of many factors, including increased cortisol, catecholamines, glucagon, growth hormone, gluconeogenesis, and glycogenolysis. Insulin resistance may also be a contributing factor. Acute hyperglycaemia is associated with poor outcomes from a wide range of acute illnesses including myocardial infarction, [2] stroke, [3] trauma and pneumonia [4]. Hyperglycaemia is thus associated with a poor outcome from a wide range of acute illnesses. However, the relationship between blood glucose levels and clinical outcomes in AECOPD has not been fully studied. The present study was undertaken to determine the relationship between blood glucose concentrations, HBA1c levels and clinical outcomes in patients of AECOPD.

Incidence and control of steroid-induced hyperglycaemia in hospitalised patients at a tertiary care centre for lung diseases

“…High blood glucose (BG) levels have been associated with increased infection rates, poor wound healing, longer hospital stays, higher treatment costs and higher mortality during hospitalisation [ 5 – 9 ]. In patients with acute exacerbations of chronic obstructive pulmonary disease (COPD), hyperglycaemia has been linked to worse outcomes [ 10 , 11 ]. A meta-analysis showed that intensive glycaemic control was associated with a lower risk of infection in hospitalised patients [ 12 ].…”