Impact of glycemic control on the severity of chronic obstructive pulmonary disease in patients with coexisting type 2 diabetes mellitus

Abstract Background: As the incidence of both diabetes and chronic obstructive pulmonary disease (COPD) is growing in India, it is a challenge to converge these two chronic diseases and manage them. Studies were done to prove that coexisting diabetes mellitus (DM) is associated with poor outcome in COPD patients, but studies to show the correlation between glycemic control and severity of COPD are very few. Objective: The objective of this study was to know the impact of glycemic control on severity of COPD in Indian population and to know the impact of diabetes on outcome of treatment in COPD patients. Methodology: The present study was a hospital-based prospective study taken up among 80 patients who have been diagnosed with COPD and coexisting DM type II visiting the outpatient department of the department of pulmonary medicine. Patients were thoroughly evaluated with respect to symptoms such as shortness of breath and its severity and cough and the details of expectoration. Detailed clinical examination was done. They were subjected to routine investigations. The pulmonary function tests were conducted on the patients, and they were segregated according to the Global Initiative for Chronic Obstructive Lung Disease 2017 guidelines. Results: Age, body mass index, duration of COPD, and duration of diabetes were comparable in the two groups. The glycated hemoglobin levels and length of hospital stay were significantly more in those with poor glycemic control (PGC) compared to those with optimal glycemic control (OGC; P < 0.05). Forced expiratory volume in 1 s was severely and significantly compromised in those with PGC compared to those with OGC ( P < 0.05). Significantly, a greater number of males were in the PGC group compared to females ( P < 0.05). Severe and very severe COPD was more common in those with PGC group compared to the OGC group ( P < 0.05). Similarly, hospital admission was more common in those with PGC. Conclusions: Poor glycemic control in the patients had a significant effect on the severity of COPD.