Key result
Uncontrolled glycemia in COPD exacerbation is linked to ~82% higher 6-month rehospitalization or mortality risk.
Why the study?
Type 2 diabetes mellitus is common in COPD patients, prompting investigation into the association between glycemic control and clinical outcomes during COPD exacerbations.
Does controlled glycemia (HbA1c < 7.5%) reduce 6-month rehospitalization or mortality in patients with T2DM and COPD exacerbation compared to uncontrolled glycemia?
Cohort (n=426)
Does controlled glycemia (HbA1c < 7.5%) reduce 6-month rehospitalization or mortality in patients with T2DM and COPD exacerbation compared to uncontrolled glycemia?
Effect estimate: HR 1.82 (95% CI 1.24-2.67)
p-value: p=0.002
In patients with T2DM and COPD exacerbation, uncontrolled glycemia prior to admission is associated with a significantly higher risk of 6-month rehospitalization or mortality.
Should not change practice yet; leaves open whether glycemic optimization reduces events in T2DM-COPD exacerbation.
Background: Type 2 diabetes mellitus (T2DM) is common among patients with chronic obstructive pulmonary disease (COPD). We examined the association between glycemic control and clinical outcomes in patients with COPD exacerbation and T2DM. Methods: A retrospective study of patients with T2DM and COPD exacerbation comparing controlled (HbA1c < 7.5%) to uncontrolled (HbA1c ≥ 7.5%) glycemia prior to admission. The primary endpoint is defined as a composite of 6-month rehospitalization/mortality. Secondary endpoints included 6-month mortality and 6-month readmission. Results: Of 426 admissions, 179 (42%) had uncontrolled glycemia. The risk of rehospitalization/mortality was significantly increased in the uncontrolled group in univariate (HR1.6, 95%CI 1.11–2.3, p = 0.01) and multivariate (HR 1.82, 95%CI 1.24–2.67, p = 0.002) analyses. The risk of 6-month rehospitalization was increased in the uncontrolled group in both univariate (HR1.94, 95%CI 1.16–3.23, p = 0.011) and multivariate (HR1.98, 95%CI 1.19–3.27, p = 0.008) analyses. No difference was found between 6-month mortality risks. Conclusions: Optimal glycemic control may improve COPD management and reduce adverse outcomes.
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Kassem et al. (2025) conducted a cohort in COPD exacerbation and Type 2 diabetes mellitus (n=426). Uncontrolled glycemia (HbA1c ≥ 7.5%) vs. Controlled glycemia (HbA1c < 7.5%) was evaluated on Composite of 6-month rehospitalization/mortality (HR 1.82, 95% CI 1.24-2.67, p=0.002). Uncontrolled glycemia (HbA1c ≥ 7.5%) in COPD exacerbation increased the 6-month risk of rehospitalization or mortality compared to controlled glycemia (HR 1.82; 95% CI 1.24-2.67; p=0.002).
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