Characteristics and distribution of obesity in the Arab-American population of southeastern Michigan

Abstract Background Arab-Americans constitute ~ 5% of Michigan’s population. Estimates of obesity in Arab-Americans are not up-to-date. We aim to describe the distribution of and factors associated with obesity in an Arab-American population in Southeastern Michigan (SE MI). Methods Retrospective medical record review identified n = 2363 Arab-American patients seeking care at an Arab-American serving clinic in SE MI, located in a city which is home to a large proportion of Arab-Americans in the United States (US). Body mass index (BMI) was the primary outcome of interest. Distribution of BMI was described using percentages, and logistic regression models were constructed to examine the association between obesity, other comorbid conditions and health behaviors. This cohort was compared to Michigan’s Behavioral Risk Factor Surveillance System (BRFSS) data from 2018 (n = 9589) and to a cohort seeking care between 2013 and 2019 from a free clinic (FC) located in another city in SE MI (n = 1033). Results Of the 2363 Arab-American patients, those who were older or with HTN, DM or HLD had a higher prevalence of obesity than patients who were younger or without these comorbidities (all p-value < 0.001). Patients with HTN were 3 times as likely to be obese than those without HTN (95% CI: 2.41–3.93; p < 0.001). Similarly, the odds of being obese were 2.5 times higher if the patient was diabetic (95% CI: 1.92–3.16; p < 0.001) and 2.2 times higher if the patient had HLD (95% CI: 1.75–2.83; p < 0.001). There was no significant difference in obesity rates between Arab-Americans (31%) and the BRFSS population (32.6%). Compared to Arab-Americans, patients seen at the FC had a higher obesity rate (52.6%; p < 0.001) as well as significantly higher rates of HTN, DM and HLD (all p < 0.001). Conclusion Overall obesity rates in Arab-Americans were comparable to the population-based BRFSS rates, and lower than the patients seen at the FC. Further studies are required to understand the impact of obesity and the association of comorbidities in Arab-Americans.

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Trends and Prevalence of Obesity in the Arab-American Population of Southeast Michigan and Comparison with their Counterparts

10.21203/rs.3.rs-29480/v1 ◽

2020 ◽

Author(s):

Saivaishnavi Kamatham ◽

Joseph Trak ◽

Suma Alzouhayli ◽

Ziad Fehmi ◽

Nabil Rahoui ◽

...

Keyword(s):

Social Services ◽

Arab Americans ◽

Arab American ◽

P Value ◽

American Population ◽

Free Clinic ◽

Patients Âgés ◽

Significant Difference ◽

Prevalence Of Obesity ◽

The Impact

Abstract Background Arab-Americans constitute ~ 5% of Michigan’s population. Estimates of obesity in Arab-Americans are not up-to-date. Here we describe the distribution of, and factors associated with obesity in an Arab-American population.Methods Arab-American patients, ages 18–98 years, from Arab Community Center for Economic and Social Services (ACCESS) clinic located in Dearborn, Michigan were identified from medical records. Retrospective chart review abstracted age, sex, marital status, employment, body mass index (BMI), hypertension (HTN), diabetes mellitus (DM), hyperlipidemia (HLD), employment status, tobacco use and alcohol consumption. This cohort was compared to Michigan’s Behavioral Risk Factor Surveillance System (BRFSS) data from 2018 and to a cohort seeking care between 2013–2019 from a free clinic in Ferndale, Michigan.Results Of the 2,363 Arab-American patients from the ACCESS clinic, 67% (n = 1591) were female and 33% (n = 772) were male. Among Arab-Americans, patients who were older or with HTN, DM or HLD had a higher prevalence of obesity than patients who were younger or without these comorbidities (all p-value < 0.001). Patients with HTN were 3 times as likely to be obese than those without HTN (95% 95% CI: 2.41–3.93; p < 0.001). Similarly, the odds of being obese were 2.5 times higher if the patient was diabetic (95% CI: 1.92–3.16; p < 0.001) and 2.2 times higher if the patient had HLD (95% CI: 1.75–2.83; p < 0.001). 9,589 individuals from Michigan’s BRFSS data were included in the study and no significant difference in obesity rates between Arab-Americans (31%) and the BRFSS population (32.6%) was noted. Compared to Arab-Americans, patients seen at the free clinic (n = 1,033) had a higher obesity rate (52.6%; p < 0.001) as well as significantly higher rates of HTN, DM and HLD (all p < 0.001). In Arab-Americans, a trend was observed in which obesity increased with age upto 44 years and declined thereafter. This was not the case in BRFSS and FCFC patients, where consistent increase in obesity was seen with increasing age.Conclusion Obesity rates in Arab-Americans were comparable to their BRFSS counterparts, and lower than their FCFC counterparts. Further studies are required to understand the impact of obesity and the association of comorbidities in Arab-Americans residing in the US.

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Abstract 17019: Obesity and Cardiovascular Health in Young American Adults

Circulation ◽

10.1161/circ.142.suppl_3.17019 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Sarabjeet S Suri ◽

Vibhu Parcha ◽

Rajat Kalra ◽

Garima Arora ◽

Pankaj Arora

Keyword(s):

Risk Factors ◽

Young Adults ◽

Cardiovascular Health ◽

Piecewise Linear ◽

The United States ◽

Obesity Prevalence ◽

Logistic Regression Models ◽

Prevalence Of Obesity ◽

Adjusted Logistic Regression ◽

The Impact

Background: The growing epidemic of obesity in the United States (US) is associated with cardiovascular (CV) morbidity and mortality. We evaluated the impact of the increasing obesity prevalence on the CV health of young American adults. Methods: The age-adjusted weighted prevalence of hypertension, diabetes, and hypercholesterolemia was estimated from the 2008-2018 National Health and Nutrition Examination Survey (NHANES) in American adults aged 18-44 years, stratified by the presence of obesity. The trends were evaluated using a piecewise linear regression approach. The odds for CV risk factors were estimated using multivariable-adjusted logistic regression models. Results: Among 14,919 young adults, the prevalence of obesity was 33.9% (95% CI: 32.6-35.3%). Obese young adults were more likely to be non-Hispanic Blacks and in lower socioeconomic and educational attainment strata (p<0.05 for all). Obese young adults had a greater risk of having hypertension (adjusted odds ratio [aOR]: 3.0 [95% CI: 2.7-3.4]), diabetes (aOR: 4.3 [95% CI: 3.3-5.6]), and hyperlipidemia (aOR: 1.47 [95% CI: 1.3-1.7]). Among obese, hypertension increased from 36.5% (33.9-39.1%) in 2007-2010 to 39.4% (35.6-43.1%) in 2015-2018 (p= 0.07) and diabetes increased from 4.7% (3.6-5.8%) in 2007-2010 to 7.1% (5.3-9.0%) in 2015-2018 (p=0.11). A modest increase in diabetes was seen in non-obese individuals ( Table ). Hypercholesterolemia prevalence remained unchanged from 12.6% (95% CI: 10.6-14.7%) 2007-2010 to 10.9% (95% CI: 9.0-12.8%) in 2015-2018 (p=0.27) among obese young adults. Non-obese young adults showed a decline in hypercholesterolemia from 9.5% (95% CI: 8.0-11.0%) in 2007- 2010 to 7.1% (95% CI: 5.8-8.4%) in 2015-2018 (p=0.002). Conclusions: Nearly one-in-every three young American adults have obesity, which is accompanied by a two-fold higher prevalence of CV risk factors. The CV morbidity in young adults is expected to increase with an increasing prevalence of obesity..

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Shooting from the ‘Scrip: Scope of Practice Laws and Access to Immunizations in the Pharmacy Setting

Vaccines ◽

10.3390/vaccines9050444 ◽

2021 ◽

Vol 9 (5) ◽

pp. 444

Author(s):

Charles Stoecker

Keyword(s):

Positive Impact ◽

National Level ◽

State Level ◽

The United States ◽

Scope Of Practice ◽

Patient Specific ◽

Behavioral Risk ◽

Influenza Immunization ◽

Immunization Rates ◽

The Impact

In the past two decades, most states in the United States have added authorization for pharmacists to administer some vaccinations. Expansions of this authority have also come with prescription requirements or other regulatory burdens. The objective of this study was to evaluate the impact of these expansions on influenza immunization rates in adults age 65 and over. A panel data, differences-in-differences regression framework to control for state-level unobserved confounders and shocks at the national level was used on a combination of a dataset of state-level statute and regulatory changes and influenza immunization data from the Behavioral Risk Factor Surveillance System. Giving pharmacists permission to vaccinate had a positive impact on adult influenza immunization rates of 1.4 percentage points for adults age 65 and over. This effect was diminished by the presence of laws requiring pharmacists to obtain patient-specific prescriptions. There was no evidence that allowing pharmacists to administer vaccinations led patients to have fewer annual check-ups with physicians or not have a usual source of health care. Expanding pharmacists’ scope of practice laws to include administering the influenza vaccine had a positive impact on influenza shot uptake. This may have implications for relaxing restrictions on other forms of care that could be provided by pharmacists.

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Caring for Older Patients With Cancer: Estimates of the Prevalence, Burden, and Unmet Needs of Caregivers in the United States

Innovation in Aging ◽

10.1093/geroni/igaa057.2412 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 690-690

Author(s):

Erin Kent

Keyword(s):

Family Caregivers ◽

Older Patients ◽

Unmet Needs ◽

The United States ◽

Population Based ◽

Data Sources ◽

Behavioral Risk ◽

Ripple Effect ◽

The Us ◽

National Trends

Abstract In 2020, ~1.8 million Americans are expected to be newly diagnosed with cancer, with approximately 70% of cases diagnosed over the age of 65. Cancer can have a ripple effect, impacting not just patients themselves, but their family caregivers. This presentation will provide an overview of the estimates of the number of family caregivers caring for individuals with cancer in the US, focusing on older patients, from several population-based data sources: Caregiving in the US 2020, the Health Information National Trends Survey (HINTS, 2017-2019), the Behavioral Risk Factors Surveillance System (BRFSS, 2015-2019), and the National Health and Aging Trends (NHATS) Survey. The presentation will compare features of the data sources to give a comprehensive picture of the state of cancer caregiving. In addition, the presentation will highlight what is known about the experiences of cancer caregivers, including caregiving characteristics, burden, unmet needs, and ideas for improving support for family caregivers.

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The Association of Antibiotic (ATB) exposure prior to immune checkpoint inhibitor (ICI) treatment on early emergency room and hospitalization utilization: A population-based study.

Journal of Clinical Oncology ◽

10.1200/jco.2020.39.28_suppl.304 ◽

2021 ◽

Vol 39 (28_suppl) ◽

pp. 304-304

Author(s):

Lawson Eng ◽

Rinku Sutradhar ◽

Yue Niu ◽

Ning Liu ◽

Ying Liu ◽

...

Keyword(s):

Emergency Room ◽

Acute Care ◽

Therapeutic Option ◽

Population Based ◽

Dose Effect ◽

Care Utilization ◽

Comorbidity Score ◽

Logistic Regression Models ◽

Acute Care Utilization ◽

The Impact

304 Background: ICIs are becoming a common therapeutic option for many solid tumors. Prior studies have shown that ATB exposure can negatively impact ICI outcomes through gut microbiome changes leading to poorer overall survival; however, less is known about the potential impact of ATB exposure on toxicities from ICI. We undertook a population-based retrospective cohort study in patients receiving ICIs to evaluate the impact of ATB exposure on early acute care use, defined as emergency department visit or hospitalization, within 30 days of initiation of ICI therapy. Methods: Administrative data was utilized to identify a cohort of cancer patients > 65 years of age receiving ICIs from June 2012 to October 2018 in Ontario, Canada. We linked databases deterministically to obtain socio-demographic and clinical co-variates, ATB prescription claims and acute care utilization. Patients were censored if they died within 30 days of initiating ICI therapy. The impact of ATB exposure within 60 days prior to starting ICI on early acute care use was evaluated using multi-variable logistic regression models, adjusted for age, gender, rurality, recent hospitalization within 60 days prior to starting ICI and comorbidity score. Results: Among 2737 patients (median age 73 years), 43% received Nivolumab, 41% Pembrolizumab and 13% Ipilimumab, most commonly for lung cancer (53%) or melanoma (34%). Of these patients, 19% had ATB within 60 days prior to ICI with a median ATB treatment duration of 9 days (SD = 13). 647 (25%) patients had an acute care episode within 30 days of starting ICIs; 182 (7%) patients passed away within 30 days without acute care use and were censored from further analyses. Any ATB exposure within 60 days prior to ICI was associated with greater likelihood of acute care use (aOR = 1.34 95% CI [1.07-1.67] p = 0.01). A dose effect was seen based on weeks of ATB exposure within 60 days prior to ICI (aOR = 1.12 per week [1.04-1.21] p = 0.004) and early acute care use. ATB class analysis identified that exposure to penicillins (aOR = 1.54 [1.11-2.15] p = 0.01) and fluoroquinolones (aOR = 1.55 [1.11-2.17] p = 0.01) within 60 days of starting ICIs were associated with a greater likelihood of acute care use, while there was no significant association between cephalosporin exposure and early acute care use (p > 0.05). Conclusions: Exposure to ATBs, specifically fluoroquinolones and penicillins, prior to ICI therapy is associated with greater likelihood of hospitalization or emergency room visits within 30 days after initiation of ICIs, even after adjustment for relevant co-variates including age, comorbidity score and recent hospitalization prior to ICI initiation. Further studies are required to better understand the mechanisms of recent ATB exposure on early acute care use among patients receiving ICIs.

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Abstract 257: Urban Teaching and Non-Teaching Hospitals Outcomes: Myocardial Infarction

Circulation Cardiovascular Quality and Outcomes ◽

10.1161/circoutcomes.10.suppl_3.257 ◽

2017 ◽

Vol 10 (suppl_3) ◽

Author(s):

Priscilla O Okunji ◽

Johnnie Daniel

Keyword(s):

Myocardial Infarction ◽

Mortality Rate ◽

Income Group ◽

The United States ◽

Teaching Hospitals ◽

Age Difference ◽

Age Group ◽

Urban Teaching ◽

Significant Difference ◽

The Impact

Background: Patients with myocardial infarction reportedly have different outcomes on discharge according to hospital characteristics. In the present study, we evaluated the differences between urban teaching hospitals (UTH) and non-teaching hospitals (NTH), discharged in 2012. We also investigated on the outcomes. Methods: Sample of 117,808 subjects diagnosed with myocardial infarction were extracted from a nationwide inpatient stay dataset using the International Classification Data, ICD 9 code 41000 in the United States, according to hospital location, size, and teaching status. Results: The analysis of the data showed that more whites were admitted to both teaching and non teaching hospitals with more males (~24%) admitted than their female counterparts. However, blacks were admitted more (~15%) in urban teaching hospitals than medium urban non teaching hospitals. Age difference was noted as well, while age group (60-79 years) were admitted more in UTH, inversely urban non-teaching hospitals admitted more older (80 years or older) age group. A significant difference (~28%) was observed in both hospital categories with UTH admitting more patients of $1.00 - $38,999.00 income group than other income categories. In addition, it was observed that patients with MI stayed more (~5%) for 14 or more days, and charged more especially for income group of $80,000 or above in UTH than NTH. No significant difference was found in the mortality rate for both hospital categories. Conclusion: The overall outcomes showed that the mortality rate between urban teaching and non-teaching hospitals were non significant, though the inpatients MI stayed longer and were charged more in UTH than NTH. The authors call for the study to be replicated with a higher level of statistical measures to ascertain the impact of the variables on the outcomes for a more validated result.

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Evolving oncology provider perspectives on care delivery during the COVID-19 pandemic.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.e18609 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. e18609-e18609

Author(s):

Divya Ahuja Parikh ◽

Meera Vimala Ragavan ◽

Sandy Srinivas ◽

Sarah Garrigues ◽

Eben Lloyd Rosenthal ◽

...

Keyword(s):

Cancer Care ◽

Care Delivery ◽

The United States ◽

Advanced Practice ◽

Curative Surgery ◽

Time Points ◽

Patients With Cancer ◽

Provider Perspectives ◽

Significant Difference ◽

The Impact

e18609 Background: The COVID-19 pandemic prompted rapid changes in cancer care delivery. We sought to examine oncology provider perspectives on clinical decisions and care delivery during the pandemic and to compare provider views early versus late in the pandemic. Methods: We invited oncology providers, including attendings, trainees and advanced practice providers, to complete a cross-sectional online survey using a variety of outreach methods including social media (Twitter), email contacts, word of mouth and provider list-serves. We surveyed providers at two time points during the pandemic when the number of COVID-19 cases was rising in the United States, early (March 2020) and late (January 2021). The survey responses were analyzed using descriptive statistics and Chi-squared tests to evaluate differences in early versus late provider responses. Results: A total of 132 providers completed the survey and most were white (n = 73/132, 55%) and younger than 49 years (n = 88/132, 67%). Respondents were attendings in medical, surgical or radiation oncology (n = 61/132, 46%), advanced practice providers (n = 48/132, 36%) and oncology fellows (n = 16/132, 12%) who predominantly practiced in an academic medical center (n = 120/132, 91%). The majority of providers agreed patients with cancer are at higher risk than other patients to be affected by COVID-19 (n = 121/132, 92%). However, there was a significant difference in the proportion of early versus late providers who thought delays in cancer care were needed. Early in the pandemic, providers were more likely to recommend delays in curative surgery or radiation for early-stage cancer (p < 0.001), delays in adjuvant chemotherapy after curative surgery (p = 0.002), or delays in surveillance imaging for metastatic cancer (p < 0.001). The majority of providers early in the pandemic responded that “reducing risk of a complication from a COVID-19 infection to patients with cancer” was the primary reason for recommending delays in care (n = 52/76, 68%). Late in the pandemic, however, providers were more likely to agree that “any practice change would have a negative impact on patient outcomes” (p = 0.003). At both time points, the majority of providers agreed with the need for other care delivery changes, including screening patients for infectious symptoms (n = 128/132, 98%) and the use of telemedicine (n = 114/132, 86%) during the pandemic. Conclusions: We found significant differences in provider perspectives of delays in cancer care early versus late in the pandemic which reflects the swiftly evolving oncology practice during the COVID-19 pandemic. Future studies are needed to determine the impact of changes in treatment and care delivery on outcomes for patients with cancer.

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Support for cigarette filter waste policies among US adults

Tobacco Control ◽

10.1136/tobaccocontrol-2020-056451 ◽

2021 ◽

pp. tobaccocontrol-2020-056451

Author(s):

Minal Patel ◽

Alison F Cuccia ◽

Shanell Folger ◽

Adam F Benson ◽

Donna Vallone ◽

...

Keyword(s):

Smoking Status ◽

Population Based ◽

Tobacco Product ◽

Cross Sectional ◽

Cigarette Filter ◽

Logistic Regression Models ◽

Knowledge And Beliefs ◽

Cigarette Butts ◽

Using Data ◽

The Impact

IntroductionLittle is known on whether cigarette filter-related knowledge or beliefs are associated with support for policies to reduce their environmental impact.MethodsA cross-sectional, population-based sample of US adults aged 18–64 years (n=2979) was used to evaluate filter-related knowledge and beliefs by smoking status using data collected between 24 October 2018 and 17 December 2018. Multivariate logistic regression models explored whether these knowledge and belief items were associated with support for two policies, a US$0.75 litter fee and a ban on sales of filtered cigarettes, controlling for demographic characteristics and smoking status.ResultsRegardless of smoking status, 71% did not know plastic was a cigarette filter component and 20% believed filters were biodegradable. Overall, 23% believed filters reduce health harms and 60% believed filters make it easier to smoke; 90% believed cigarette butts are harmful to the environment. Individuals believing cigarette butts harmed the environment were more likely to support a litter fee (adjusted OR (aOR)=2.33, 95% CI: 1.71 to 3.17). Individuals believing that filters are not biodegradable had higher odds of supporting a litter fee (OR=1.47, 95% CI: 1.15 to 1.88). Respondents believing that filters do not make cigarettes less harmful were more likely to support a litter fee (aOR=1.50, 95% CI: 1.20 to 1.88) and filter ban (aOR=2.03, 95% CI: 1.64 to 2.50). Belief that filters make it easier to smoke was associated with decreased support for a filter ban (aOR=0.69, 95% CI: 0.58 to 0.83).ConclusionsComprehensive efforts are needed to educate the public about the impact of cigarette filters in order to build support for effective tobacco product waste policy.

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Do Socioeconomic Conditions Explain Ethnic Inequalities in Tooth Loss among US Adults?

Ethnicity & Disease ◽

10.18865/ed.28.3.201 ◽

2018 ◽

Vol 28 (3) ◽

pp. 201

Author(s):

Fatma W. Nazer ◽

Wael Sabbah

Keyword(s):

Ethnic Differences ◽

Tooth Loss ◽

Family Income ◽

The United States ◽

Outcome Variable ◽

Behavioral Risk ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Logistic Regression Models ◽

Ethnic Inequalities

Objective: To assess whether there are ethnic differences in tooth loss among adult Americans aged <40 years and whether socioeconomic position attenuates these differences if they exist.Methods: Data were from the 2014 Behavioral Risk Factor Surveillance System, a health-related telephone cross-sectional survey of a nationally representative sample of US adults. Tooth loss (one tooth or more) was used as the outcome variable. Ethnicity was the main explanatory variable. Family income, education and health insurance were also used in the analysis. Logistic regression models for tooth loss were constructed adjusting for demographic (age, sex, and ethnicity), socioeconomic indicators (income and education), health insurance, dental visits, smoking and diabetes.Results: A total of 76,273 participants were included in the analysis. The prevalence of tooth loss was highest among Blacks (33.7%). Hispanics and other ethnic groups had a higher prevalence of tooth loss than Whites, 29.1% (95%CI: 27.7-30.6), 22.0% (95%CI: 20.3-23.8), and 20.8% (95%CI: 20.2-21.4), respectively. Blacks had odds ratios (OR) 1.98 (95%CI: 1.81-2.16) for tooth loss compared with Whites. After adjusting for socioeconomic positions (SEP), the relationship attenuated but remained significant with OR 1.71 (95%CI: 1.55-1.90).Conclusions: Despite recent changes in the health care system in the United States, ethnic inequalities in tooth loss still exist. Income and education partially explained ethnic differences in tooth loss among Americans aged <40 years.Ethn Dis. 2018;28(3):201-206; doi:10.18865/ ed.28.3.201

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Glycemic Control & Morbidity in Diabetics With COPD Exacerbation. A Retrospective Study

Journal of the Endocrine Society ◽

10.1210/jendso/bvab048.844 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. A414-A414

Author(s):

Ibrahim Naoum ◽

Abedalghani Abedalhalim ◽

Amir Aker ◽

Luai Khalaili ◽

Sameer Kassem

Keyword(s):

Mechanical Ventilation ◽

Glycemic Control ◽

Population Based ◽

Chronic Obstructive ◽

P Value ◽

Diabetic Patients ◽

Copd Exacerbation ◽

Copd Exacerbations ◽

Significant Difference ◽

The Impact

Abstract Background: Diabetes and chronic obstructive pulmonary disease (COPD) are widely prevalent and comorbidity with these diseases is quite common. However, there is limited data on the interrelation between glycemic control and COPD exacerbations in diabetic patients. Objective: To study the association between pre-admission glycemic control and COPD clinical outcomes including mortality, risk of hospital readmission and the need for mechanical ventilation. Methods: A retrospective population-based cohort study. We screened for patients with both diabetes and COPD exacerbation aged 35 years and above. Pre-admission glycemic control was defined by the last HBA1C level prior to hospitalization. Patients with HBA1C>8% were defined as uncontrolled. We evaluated the difference between controlled and uncontrolled groups in the rates of mortality, readmission and the need for mechanical ventilation. We examined demographic and clinical parameters that might reflect COPD severity including: COPD medication use, blood hemoglobin, platelets, LDH and CRP levels. Results: 513 hospitalizations with diabetes and COPD were screened. 222 hospitalization were excluded either due to unestablished diagnosis of COPD or due to lack of HBA1C test in the preceding year. Of the remaining 291, 208 admissions were with controlled diabetes whereas 83 were uncontrolled. Although not statistically significant, the rate of re-hospitalization was higher in the uncontrolled group (OR 1.99, CI 0.99–4.0, p-value 0.051). There was no statistically significant difference in mortality (OR 1.6, CI 0.73–3.5, p-value 0.243). The use of oxygen and the need for noninvasive mechanical ventilation were significantly higher in the uncontrolled group (67.5% vs. 52.4%, p-value 0.019, 33.7% versus 18.8%, p-value 0.006, respectively). There was no significant difference in possible confounders tested between the groups. Conclusion: Uncontrolled diabetes may adversely affect patients with COPD exacerbation. Larger studies are needed to conclusively determine the impact of glycemic control on COPD morbidity and mortality.

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