2016
DOI: 10.1371/journal.pone.0162903
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Metabolic Effects Associated with ICS in Patients with COPD and Comorbid Type 2 Diabetes: A Historical Matched Cohort Study

Abstract: BackgroundManagement guidelines for chronic obstructive pulmonary disease (COPD) recommend that inhaled corticosteroids (ICS) are prescribed to patients with the most severe symptoms. However, these guidelines have not been widely implemented by physicians, leading to widespread use of ICS in patients with mild-to-moderate COPD. Of particular concern is the potential risk of worsening diabetic control associated with ICS use.Here we investigate whether ICS therapy in patients with COPD and comorbid type 2 diab… Show more

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Cited by 45 publications
(43 citation statements)
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“…This negative effect was more prominent in patients prescribed the higher doses compared to those prescribed lower doses. 44 However, patients who had baseline pneumonia and diagnosis of diabetes were excluded from this study. Due to the exploratory nature of this study, we were not able to come to a concrete conclusion with regard to incidence of pneumonia and/or diabetes.…”
Section: Discussionmentioning
confidence: 99%
“…This negative effect was more prominent in patients prescribed the higher doses compared to those prescribed lower doses. 44 However, patients who had baseline pneumonia and diagnosis of diabetes were excluded from this study. Due to the exploratory nature of this study, we were not able to come to a concrete conclusion with regard to incidence of pneumonia and/or diabetes.…”
Section: Discussionmentioning
confidence: 99%
“…Moreover, in our study, the observational real-life setting reflects the reality of diabetes monitoring in this specific study population. The design we used is in line with other studies that also used a pragmatic design to conduct diabetes-related studies in primary care 31–35…”
Section: Discussionmentioning
confidence: 99%
“…Similarly, nebulized glycopyrrolate improved FEV 1 , and patient-reported outcomes in patients with COPD, irrespective of cardiovascular risk status [24]. In previous studies of patients with COPD and comorbid type 2 diabetes, ICS therapy may have a negative impact on diabetes control, and patients prescribed higher doses may be at greater risk of diabetes progression [25,26]. In the GOLD report, combination ICS/LABA or LAMA/LABA or LAMA monotherapy are recommended for GOLD D patients [1].…”
Section: Discussionmentioning
confidence: 99%