Impact of Inhaled Corticosteroid Therapy on Glycemic Control in COPDPatients: A Comparative Cross-Sectional Study

Background: Inhaled corticosteroids (ICS) are commonly used in COPD management for their anti-inflammatory benefits. However, systemic absorption of ICS may adversely affect glycemic control, particularly in long-term use. This study aimed to evaluate the impact of ICS therapy on glycemic parameters in COPD patients. Methods: This comparative cross-sectional study was conducted at Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh, from January to June 2024. A total of 320 COPD patients were enrolled, comprising 160 ICS users and 160 non-ICS users. Glycemic parameters including fasting plasma glucose (FPG), 2-hour post-breakfast plasma glucose (2HABF), and glycated hemoglobin (HbA1c) were measured. Data were analyzed using SPSS version 20.0. Results: The mean FPG (5.97 ± 1.78 mmol/L vs 5.14 ± 0.93 mmol/L, p<0.001) and 2HABF (8.98 ± 2.82 mmol/L vs 7.47 ± 1.83 mmol/L, p<0.001) were significantly higher in ICS users. Diabetic-range FPG (≥7.0 mmol/L) and 2HABF (≥11.1 mmol/L) were more prevalent in ICS users (32.5% vs 7.5% and 32.5% vs 10%, respectively; p<0.001). Although the mean HbA1c was not significantly different (p=0.082), diabetic-range HbA1c (≥6.5%) was significantly higher in ICS users (32.5% vs 10%, p<0.001). Conclusion: ICS therapy in COPD patients is associated with significant glycemic derangement. Glycemic monitoring should be routinely practiced in COPD patients receiving ICS to prevent undetected hyperglycemia.