Glycated Hemoglobin A1c-based Adjusted Glycemic Variables in Patients with Diabetes Presenting with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Overview

Journal Int J Chron Obstruct Pulmon Dis

Publisher Dove Medical Press

Specialty Pulmonary Medicine

Date 2017 Jul 26

PMID 28740373

Citations 11

Authors

Chih-Jen Yang

Wen-I Liao

Zun-Cheng Tang

Jen-Chun Wang

Chien-Hsing Lee

Wei-Chou Chang

Chin-Wang Hsu

Shih-En Tang

Shih-Hung Tsai

Affiliations

Soon will be listed here.

Abstract

Acute hyperglycemia is a common finding in patients presenting to emergency departments (EDs) with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Several studies have argued against the association between hyperglycemia at admission and adverse outcomes in patients with diabetes and an acute illness. Recent studies have shown that glucose-related variables (eg, glycemic gaps and stress hyperglycemia ratios) that are adjusted for glycated hemoglobin levels can indicate the severity of a variety of diseases. The objective of this study was to assess whether these hemoglobin A1c (HbA1c)-based adjusted average glycemic variables were associated with unfavorable outcomes in patients admitted to a hospital with AECOPD. We found that 1) pulmonary infection is a major risk factor for AECOPD; 2) a higher glycemic gap and modified stress hyperglycemia ratio were associated with the development of acute respiratory failure (ARF) in patients with diabetes admitted to an ED because of AECOPD; and 3) the glycemic gap and modified stress hyperglycemia ratio had superior discriminative power over acute hyperglycemia and HbA1c for predicting the development of ARF, although the HbA1c-adjusted glycemic variables alone were not independent risk factors for ARF.

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