George Habib1, Yusri Dar-Esaif2, Hashim Bishara3, Suheil Artul4, Samih Badarny5, Mark Chernin6, Adel Jabbour7. 1. Department of Medicine, Carmel Medical Center, Haifa, Israel; Rheumatology Clinic, Nazareth Hospital, Nazareth, Israel. Electronic address: gshabib@gmail.com. 2. Department of Medicine, Nazareth Hospital, Nazareth, Israel. 3. Pulmonary Unit, Nazareth Hospital, Nazareth, Israel. 4. Department of Radiology, Nazareth Hospital, Nazareth, Israel. 5. Department of Neurology, Carmel Medical Center, Haifa, Israel. 6. Department of Medicine, Carmel Medical Center, Haifa, Israel. 7. Central Lab, Nazareth Hospital, Nazareth, Israel.
Abstract
BACKGROUND: Corticosteroid-induced hyperglycemia is a known adverse effect. There are no studies on the impact of corticosteroid treatment on hemoglobin A1c (HbA1c) levels in type-2 diabetes patients with chronic obstructive pulmonary disease (COPD) exacerbation. METHODS: HbA1c levels were evaluated in type-2 diabetes patients with COPD exacerbation on admission to the hospital (group-1) and 3-months later. Demographic, clinical, laboratory variables and total steroid dose were documented. Age- and sex-matched group of type-2 diabetes patients with COPD who were admitted for other reasons (group-2), were asked to participate as a control group. Mann-Whitney and Chi square/Fischer's exact tests were used to compare between the parameters of the two groups. Wilcoxon's signed rank test was used to compare between HbA1c levels at baseline and 3 months later. Multi-variate linear regression analysis was used to find predictors for a change in HbA1c levels in group-1 patients. RESULTS: 23 and 21 patients in groups 1 and 2 respectively, completed the study. There were 39 male (∼89%) patients. Mean age of the patients was 66.2 ± 8.2 years. In both groups, anti-diabetic management was augmented. There was no significant change in the HbA1c levels in group-1 (p = 0.416), however there was a significant decrease in HbA1c levels in group-2 (p = 0.032). Total dose of steroids was a predictor for an increase in HbA1c levels in group-1 patients (p = 0.026). CONCLUSIONS: Type-2 diabetes patients who were treated with steroids for COPD exacerbation had no significant change in HbA1c levels. Total dose of steroids was a predictor for an increase in HbA1c levels.
BACKGROUND: Corticosteroid-induced hyperglycemia is a known adverse effect. There are no studies on the impact of corticosteroid treatment on hemoglobin A1c (HbA1c) levels in type-2 diabetespatients with chronic obstructive pulmonary disease (COPD) exacerbation. METHODS: HbA1c levels were evaluated in type-2 diabetespatients with COPD exacerbation on admission to the hospital (group-1) and 3-months later. Demographic, clinical, laboratory variables and total steroid dose were documented. Age- and sex-matched group of type-2 diabetespatients with COPD who were admitted for other reasons (group-2), were asked to participate as a control group. Mann-Whitney and Chi square/Fischer's exact tests were used to compare between the parameters of the two groups. Wilcoxon's signed rank test was used to compare between HbA1c levels at baseline and 3 months later. Multi-variate linear regression analysis was used to find predictors for a change in HbA1c levels in group-1 patients. RESULTS: 23 and 21 patients in groups 1 and 2 respectively, completed the study. There were 39 male (∼89%) patients. Mean age of the patients was 66.2 ± 8.2 years. In both groups, anti-diabetic management was augmented. There was no significant change in the HbA1c levels in group-1 (p = 0.416), however there was a significant decrease in HbA1c levels in group-2 (p = 0.032). Total dose of steroids was a predictor for an increase in HbA1c levels in group-1 patients (p = 0.026). CONCLUSIONS:Type-2 diabetespatients who were treated with steroids for COPD exacerbation had no significant change in HbA1c levels. Total dose of steroids was a predictor for an increase in HbA1c levels.
Authors: Khairil K Zulkifli; Fatimah Z Mohamed Shah; Ahmad I Ismail; Thuhairah H Abdul Rahman; Rohana A Ghani Journal: Chron Respir Dis Date: 2021 Jan-Dec Impact factor: 2.444