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Dr Joslyn Ngu, 16 Oct 2017

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Incident, pre-existing diabetes mellitus linked to poorer outcomes in COPD

17 Apr 2017
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Diabetes mellitus (DM), whether incident or pre-existing, is associated with worse clinical outcomes in patients with chronic obstructive pulmonary disease (COPD), a new study shows.

The study involved 2,015 patients (70 percent male; mean age 62.7±12.0 years) in Taiwan’s Longitudinal Health Insurance Database who had been diagnosed with COPD during at least two outpatient visits within 12 months; those who were hospitalized were also included. Exclusion criteria included having asthma or type 1 DM during the study the period and being younger than 40 at COPD diagnosis.

All-cause mortality was the primary endpoint for all COPD patients. For those without pre-existing DM, development of DM was also a primary endpoint. DM diagnoses after entry into the cohort were designated as incident DM.

In the COPD cohort, the most common comorbodities were hypertension (50 percent), coronary artery disease (23 percent) and cerebrovascular disease (18 percent). Furthermore, 16 percent (n=332) had pre-existing DM.

Those with pre-existing DM had a higher proportion of hypertension, coronary artery disease, heart failure, cerebrovascular disease, dyslipidaemia and other comorbidities compared with those without.

Of the 670 deaths (33 percent) in the COPD cohort, those with pre-existing DM had higher probabilities of mortality (hazard ratio [HR], 1.244; 95 percent CI, 1.010 to 1.532; p=0.04). There were no additive effects between DM and hypertension (p=0.72), dyslipidaemia (p=0.91), cerebrovascular disease (p=0.30), heart failure (p=0.70) and coronary artery disease (p=0.75) on mortality.

The effects of incident DM were evaluated in 304 matched COPD patients. These patients also had higher risks of mortality (HR, 1.810; 1.363 to 2.403; p<0.001). Survival was poorer for those with incident DM (p=0.027).

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Most Read Articles
Audrey Abella, 21 Jul 2017
Deficiency in vitamin A (<200 µg/L) may predict the risk of incident tuberculosis (TB) in individuals with household exposure to a person with TB, a recent study has found.
14 Mar 2016
Delamanid may be a potent treatment regimen for pulmonary multidrug-resistant tuberculosis (MDR-TB) patients, based on a study.
Pearl Toh, 22 Jun 2017
The next-generation ALK inhibitor brigatinib yielded high and durable responses in both whole-body and intracranial endpoints, with a median progression-free survival (PFS) of over 1 year in patients with ALK-positive non-small cell lung cancer (NSCLC) whose disease had progressed after crizotinib, according to the ALTA* trial.
Dr Joslyn Ngu, 16 Oct 2017

The main goal of the National Strategic Plan (NSP) for TB Control (2016 to 2020) is to reduce tuberculosis (TB) burden by ensuring universal access to timely and quality diagnosis and treatment of all types of TB, and preventing the development of drug resistant TB, says an expert.