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Glycaemic Status of Patients with Chronic Obstructive Pulmonary Disease on Inhaled Corticosteroid

Received: 21 November 2020    Accepted: 6 February 2021    Published: 27 February 2021
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Abstract

Background: Although the hyperglycaemic effects of systemic glucocorticoid therapy are well known, the effect of inhaled corticosteroids (ICS) on carbohydrate metabolism is still a subject of debate. The systemic bioavailability of ICS is claimed to be minimal and the side effects are negligible. Objectives: The aim of the study was to assess to the effect of inhaled corticosteroid on glycaemic status in patients with COPD. Methods: This Cross-sectional analytical study of COPD patients attending at Internal Medicine department of BSMMU, Dhaka, Bangladesh, between May 2016 to April 2017. After approval of the protocol by IRB and ethical committee, cross-sectional analytical study was done in the department of Internal Medicine, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka. Total 80 COPD patients were recruited consecutively upon fulfilling the inclusion criteria. Socio-demographic data and disease related data were collected by face to face interview using a semi-structured case record form. The COPD patients were categorized according to global initiative for obstructive lung diseases (GOLD) criteria. The collected data then edited, analyzed and be presented as graphs, tables & charts. Results: There was no statistical difference in the mean age of both group which was 53.85±7.9 and 56±7.6 in control and case respectively. 77.5% of the case and 72.5% of control population are indulging in smoking while only 15% from each group are non-smoker. Large number of cases are service holder and businessman 35% and 20%, which is true for control group also 20% and 47.5%. Most of the cases are from higher socioeconomic background (45%), whereas in control group it is 37.5%. In 20% cases symptoms duration was less than 5 years, where as in control group it was 42.5%. 32% of cases and 7.5% of control group were diagnosed as diabetic when fasting plasma glucose taken into account, while in case of 2- hours plasma glucose the number were 32.5% and 10% respectively and in case of HbA1c the number were 23.5% and 10% respectively. Conclusion: Pre-diabetes and diabetes are highly prevalent among people with COPD which remain undiagnosed & untreated. So, the study findings will help in early intervention of glycaemic control among COPD patients.

Published in Cardiology and Cardiovascular Research (Volume 5, Issue 1)
DOI 10.11648/j.ccr.20210501.18
Page(s) 41-48
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Glycaemic, Chronic Obstructive, Pulmonary Disease, Inhaled Corticosteroid, Plasma Glucose, Glycaemic Status

References
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[2] Garbe E. et al (2007) Systematic Review: Agranulocytosis Induced by Nonchemotherapy Drugs, Annals of Internal Medicine, 146 (9): 657-65.
[3] Allen DB et al., 2006. Effects of inhaled steroids on growth, bone metabolism and adrenal function. Advance in Pediatrics, 53, 101-110.
[4] Manino D, Thorn D, Swensen A and Holguin F., 2009. Prevalence and outcomes of diabetes, hypertension and cardiovascular disease in COPD. European Respiratory Journal, 32, 962–9.
[5] Rana J et al., 2004. Pulmonary disease, asthma, and risk of type 2 diabetes in women. Diabetes Care, 27, 2478–84.
[6] American Diabetes Association (2013). Standards of medical care in diabetes 2014 VIII: diabetes care in specific settings. Practice Guideline 2014. Available from www.care.diabetes journals.ogr/content/37/supplement-1/S4,full#sec-179.
[7] Kozower M, Veatch L and Kaplan MM. 1974. Decreased clearance of prednisolone, a factor in the development of corticosteroid side effects. The Journal of Clininical Endocrinology and Metabolism, 38, 407.
[8] Schacke et al (2002), Mechanisms involved in the side effects of glucocorticoids, Chest-96 (1): 23-43.
[9] Faul et al: The effect of an inhaled corticosteroid on glucose control in type 2 diabetes. Clinical Med Res 2009; 7: 14-20.
[10] Slatore CG et al., 2009. The association of inhaled corticosteroid use with serum glucose concentration in a large cohort. American Journal of Medicine, 122, 472-8.
[11] Suissa S, Kezouh A and Ernst P., 2010. Inhaled corticosteroids and the risks of diabetes onset and progression. American Journal of Medicine, 123, 1001e6.
[12] De Koster (2014), higher proportion of G2P [4] rotaviruses in vaccinated hospitalized cases compared with unvaccinated hospitalized cases, despite high vaccine effectiveness against heterotypic G2P [4] rotaviruses, CMI 20 (10): 0702-0710.
[13] Corrado A and Rossi A., 2012. How far is real life from COPD therapy guidelines? An Italian observational study. Respiratory Medicine 106, 989–97.
[14] Faul et al (2002), Alterations in Airway Inflammation and Lung Function during Corticosteroid Therapy for Atopic Asthma. The Chest-121: 1414-1420.
[15] Mirrakhimov, et al. Chronic obstructive pulmonary disease and glucose metabolism: a bitter sweet symphony. Cardiovasc Diabetol 11, 132 (2012). https://doi.org/10.1186/1475-2840-11-132.
[16] Christopher et al. (2015), Association of COPD with risk for pulmonary infections requiring hospitalization in HIV-infected Veterans, PMC (2015): 70 (3): 280-288.
[17] Kian et al (2012). Graphene Photonics, Plasmonics, and Broadband Optoelectronic Devices, Nano 6 (5): 3677-3694.
[18] Wolfs et al, (2005) Diabetes mellitus. In Brooks Clinical Pediatric Endocrinology. 5th edition, Oxford: Blackwell Publishing Ltd, 436-473.
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    Mohammad Abul Kalam Azad Khan, Kabirul Hasan Bin Rakib, Saiful Islam Patwary, Abu Saleh Md. Sirajum Munir, Md., et al. (2021). Glycaemic Status of Patients with Chronic Obstructive Pulmonary Disease on Inhaled Corticosteroid. Cardiology and Cardiovascular Research, 5(1), 41-48. https://doi.org/10.11648/j.ccr.20210501.18

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    ACS Style

    Mohammad Abul Kalam Azad Khan; Kabirul Hasan Bin Rakib; Saiful Islam Patwary; Abu Saleh Md. Sirajum Munir; Md., et al. Glycaemic Status of Patients with Chronic Obstructive Pulmonary Disease on Inhaled Corticosteroid. Cardiol. Cardiovasc. Res. 2021, 5(1), 41-48. doi: 10.11648/j.ccr.20210501.18

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    AMA Style

    Mohammad Abul Kalam Azad Khan, Kabirul Hasan Bin Rakib, Saiful Islam Patwary, Abu Saleh Md. Sirajum Munir, Md., et al. Glycaemic Status of Patients with Chronic Obstructive Pulmonary Disease on Inhaled Corticosteroid. Cardiol Cardiovasc Res. 2021;5(1):41-48. doi: 10.11648/j.ccr.20210501.18

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  • @article{10.11648/j.ccr.20210501.18,
      author = {Mohammad Abul Kalam Azad Khan and Kabirul Hasan Bin Rakib and Saiful Islam Patwary and Abu Saleh Md. Sirajum Munir and Md. and Sohel Ahmed and Mazharul Islam and Dr. Rabeya Bosri and Shamim Ahmed and Md. Abul Kalam Azad and Md. Abdur Rahim},
      title = {Glycaemic Status of Patients with Chronic Obstructive Pulmonary Disease on Inhaled Corticosteroid},
      journal = {Cardiology and Cardiovascular Research},
      volume = {5},
      number = {1},
      pages = {41-48},
      doi = {10.11648/j.ccr.20210501.18},
      url = {https://doi.org/10.11648/j.ccr.20210501.18},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ccr.20210501.18},
      abstract = {Background: Although the hyperglycaemic effects of systemic glucocorticoid therapy are well known, the effect of inhaled corticosteroids (ICS) on carbohydrate metabolism is still a subject of debate. The systemic bioavailability of ICS is claimed to be minimal and the side effects are negligible. Objectives: The aim of the study was to assess to the effect of inhaled corticosteroid on glycaemic status in patients with COPD. Methods: This Cross-sectional analytical study of COPD patients attending at Internal Medicine department of BSMMU, Dhaka, Bangladesh, between May 2016 to April 2017. After approval of the protocol by IRB and ethical committee, cross-sectional analytical study was done in the department of Internal Medicine, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka. Total 80 COPD patients were recruited consecutively upon fulfilling the inclusion criteria. Socio-demographic data and disease related data were collected by face to face interview using a semi-structured case record form. The COPD patients were categorized according to global initiative for obstructive lung diseases (GOLD) criteria. The collected data then edited, analyzed and be presented as graphs, tables & charts. Results: There was no statistical difference in the mean age of both group which was 53.85±7.9 and 56±7.6 in control and case respectively. 77.5% of the case and 72.5% of control population are indulging in smoking while only 15% from each group are non-smoker. Large number of cases are service holder and businessman 35% and 20%, which is true for control group also 20% and 47.5%. Most of the cases are from higher socioeconomic background (45%), whereas in control group it is 37.5%. In 20% cases symptoms duration was less than 5 years, where as in control group it was 42.5%. 32% of cases and 7.5% of control group were diagnosed as diabetic when fasting plasma glucose taken into account, while in case of 2- hours plasma glucose the number were 32.5% and 10% respectively and in case of HbA1c the number were 23.5% and 10% respectively. Conclusion: Pre-diabetes and diabetes are highly prevalent among people with COPD which remain undiagnosed & untreated. So, the study findings will help in early intervention of glycaemic control among COPD patients.},
     year = {2021}
    }
    

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  • TY  - JOUR
    T1  - Glycaemic Status of Patients with Chronic Obstructive Pulmonary Disease on Inhaled Corticosteroid
    AU  - Mohammad Abul Kalam Azad Khan
    AU  - Kabirul Hasan Bin Rakib
    AU  - Saiful Islam Patwary
    AU  - Abu Saleh Md. Sirajum Munir
    AU  - Md.
    AU  - Sohel Ahmed
    AU  - Mazharul Islam
    AU  - Dr. Rabeya Bosri
    AU  - Shamim Ahmed
    AU  - Md. Abul Kalam Azad
    AU  - Md. Abdur Rahim
    Y1  - 2021/02/27
    PY  - 2021
    N1  - https://doi.org/10.11648/j.ccr.20210501.18
    DO  - 10.11648/j.ccr.20210501.18
    T2  - Cardiology and Cardiovascular Research
    JF  - Cardiology and Cardiovascular Research
    JO  - Cardiology and Cardiovascular Research
    SP  - 41
    EP  - 48
    PB  - Science Publishing Group
    SN  - 2578-8914
    UR  - https://doi.org/10.11648/j.ccr.20210501.18
    AB  - Background: Although the hyperglycaemic effects of systemic glucocorticoid therapy are well known, the effect of inhaled corticosteroids (ICS) on carbohydrate metabolism is still a subject of debate. The systemic bioavailability of ICS is claimed to be minimal and the side effects are negligible. Objectives: The aim of the study was to assess to the effect of inhaled corticosteroid on glycaemic status in patients with COPD. Methods: This Cross-sectional analytical study of COPD patients attending at Internal Medicine department of BSMMU, Dhaka, Bangladesh, between May 2016 to April 2017. After approval of the protocol by IRB and ethical committee, cross-sectional analytical study was done in the department of Internal Medicine, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka. Total 80 COPD patients were recruited consecutively upon fulfilling the inclusion criteria. Socio-demographic data and disease related data were collected by face to face interview using a semi-structured case record form. The COPD patients were categorized according to global initiative for obstructive lung diseases (GOLD) criteria. The collected data then edited, analyzed and be presented as graphs, tables & charts. Results: There was no statistical difference in the mean age of both group which was 53.85±7.9 and 56±7.6 in control and case respectively. 77.5% of the case and 72.5% of control population are indulging in smoking while only 15% from each group are non-smoker. Large number of cases are service holder and businessman 35% and 20%, which is true for control group also 20% and 47.5%. Most of the cases are from higher socioeconomic background (45%), whereas in control group it is 37.5%. In 20% cases symptoms duration was less than 5 years, where as in control group it was 42.5%. 32% of cases and 7.5% of control group were diagnosed as diabetic when fasting plasma glucose taken into account, while in case of 2- hours plasma glucose the number were 32.5% and 10% respectively and in case of HbA1c the number were 23.5% and 10% respectively. Conclusion: Pre-diabetes and diabetes are highly prevalent among people with COPD which remain undiagnosed & untreated. So, the study findings will help in early intervention of glycaemic control among COPD patients.
    VL  - 5
    IS  - 1
    ER  - 

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Author Information
  • Department of Cardiology, National Institute of Cardiovascular Diseases (NICVD), Sher-e-Bangla Nagar, Dhaka, Bangladesh

  • Department of Medicine, Dhaka Medical College Hospital, Dhaka, Bangladesh

  • Department of Medicine, Chandpur Medical College, Chandpur, Bangladesh

  • Department of Medicine, Chandpur Medical College, Chandpur, Bangladesh

  • Department of Medicine, 250 Bedded General Hospital, Brahmanbaria, Bangladesh

  • Department of Gynae and Obstetrics, Mugda Medical College Hospital, Mugda, Dhaka, Bangladesh

  • Department of Respitatory Medicine, Bangbandhu Sheikh Mujib Medical University, Shahbag, Dhaka, Bangladesh

  • Department of Internal Medicine, Bangbandhu Sheikh Mujib Medical University Shahbag, Dhaka, Bangladesh

  • Department of Internal Medicine, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka, Bangladesh

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