Effect of ICS on glycaemic control in patients with COPD and comorbid type 2 diabetes: Historical case-matched cohort study

Richard Russell, David Price, Rafael Mares, Anne Burden, Derek Skinner, Helga Mikkelsen, Niels H. Chavannes, Janwillem W.H. Kocks, Jeffrey W. Stephens, John Haughney

Research output: Contribution to journalMeeting AbstractAcademic

Abstract

Introduction: Type 2 diabetes mellitus (T2DM) is a common comorbidity of COPD. ICS treatment may be associated with reduced glycaemic control and increased risk of diabetic complications. Aim: To assess the effects of ICS on diabetes control in patients (pts) with COPD and T2DM. Methods: 2 UK primary care databases of >11 million pts were searched (2008- 2012) for pts with COPD and T2DM receiving ICS/non-ICS therapy. Pts were matched 1:1 for age, sex, body mass index, baseline HbA1c, COPD severity and medications. Primary endpoint: HbA1c (change from baseline) during the 12-18- month observation period. A subgroup analysis was conducted in pts with mild to moderate COPD (GOLD A+B), for whom ICS are not recommended by GOLD. Data were analysed using a generalised linear model with an identity link function and normal distribution; potential confounders were analysed for collinearity using Spearman's correlation coefficients. Results: 682 pts matched per arm; mean age 70 years; 73% men; 95% current or ex-smokers. Pts receiving ICS had a significantly greater increase in HbA1c vs non-ICS pts, notably for GOLD A+B groups. Higher cumulative ICS doses were associated with loss of glycaemic control (Table). (Table presented) Conclusions: ICS therapy for COPD is associated with reduced glycaemic control. Risk/benefit analyses of ICS in COPD should be considered, especially in pts with T2DM.
Original languageEnglish
Article numberPA867
JournalEuropean Respiratory Journal
Volume48
Issue numberSupplement 60
DOIs
Publication statusPublished - 1-Sep-2016

Keywords

  • gold
  • hemoglobin A1c
  • aged
  • body mass
  • chronic obstructive lung disease
  • clinical trial
  • cohort analysis
  • controlled study
  • correlation coefficient
  • data base
  • diabetes control
  • drug megadose
  • female
  • glycemic control
  • human
  • identity
  • major clinical study
  • male
  • non insulin dependent diabetes mellitus
  • normal distribution
  • normal human
  • primary medical care
  • risk benefit analysis
  • smoking
  • statistical model

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