scholarly journals The Prevalence of Diabetes Mellitus in Chronic Obstructive Pulmonary Disease Patients

2020 ◽  
Vol 40 (1) ◽  
pp. 48-57
Author(s):  
Mariska Pangaribuan ◽  
Faisal Yunus ◽  
Triya Damayanti ◽  
Rochsismandoko Rochsismandoko

Backgrounds: Type 2 diabetes mellitus (DM) is a common comorbidity of COPD. COPD may be considered as a risk factor for new onset type 2 DM via multiple pathophysiological alterations such as systemic inflammation, smoking, oxidative stress, obesity and inhaled corticosteroid use. Exact prevalence of DM in COPD patients in Indonesia still unclear. Co-morbid conditions like DM have great impact on the outcome of COPD in the form of severity, morbidity and mortality. Methods: A cross sectional study was done in Asthma-COPD clinic Persahabatan Hospital from February to March 2017 to screen COPD patients for DM. Sixty-four subjects were recruited. Interview, physical examination and laboratory testing were performed in all subjects. Results: A total of 64 patients with COPD (Males=60, Female=4) with mean age 65±8.7 were screened for DM. Patients with known history of DM were 12 subjects (18.8%) and were enrolled as known DM cases. Remaining 52 subjects (81.3%) whose DM status was unclear were screened by random or fasting blood sugar and HbA1c. Two subjects (3.1%) were considered as newly diagnosed DM cases. Prevalence of DM in present study was 21.9%. Number of patients with pre-diabetes was 16 subjects (25%). There was no significant relationship between gender, age, smoking, nutritional status, airflow limitation and inhaled corticosteroid use in occurrence of DM among COPD patients. Conclusions: Prevalence of DM in COPD patients in the present study is 21.9%. It is important to screen all COPD patients for DM routinely. (J Respir Indo. 2020; 40(1): 48-57)

2020 ◽  
Vol 7 (4) ◽  
pp. 634
Author(s):  
Sujit Kumar ◽  
Vimal Kumar Nishad ◽  
Amitabh Das Shukla ◽  
Santosh Kumar Chaudhary

Background: Serum uric acid (sUA) levels were previously found to be correlated with hypoxic states. We aimed to determine the levels of sUA in COPD patients and to evaluate whether sUA level can be used as predictors of exacerbation risk and disease severity.Methods: This cross-sectional study included COPD patients and healthy controls. The sUA levels in each group were evaluated and their correlations with the study parameters were investigated. ROC analyses for exacerbation risk were reported.Results: The study included 106 COPD patients and 110 healthy controls. The mean sUA levels were significantly higher in patients with COPD compared to healthy controls (p<0.05). Mean sUA levels were compared with different stages of COPD according to GOLD criteria. Stage 4 COPD subjects had highest sUA levels compared to other stages. Statistically significant trend was observed for GOLD staging of disease (p<0.05). Surprisingly non-smokers were having higher uric acid level than smokers (p<0.05). The ROC analyses indicated that sUA levels can be useful in predicting exacerbation risk (AUC, 0.412) especially at higher cut-off values, but with low specificity.Conclusions: Study suggested that sUA levels increased in patients with COPD compared to healthy controls. At higher cut-off values sUA levels might be useful in predicting COPD exacerbation risk and disease severity. However, more prospective cohort studies with large number of participants are needed to further analyse the possible different prognostic roles of hyperuricemia.


Author(s):  
Atul Tiwari ◽  
SK Piruwa ◽  
SK Agrawaal ◽  
GN Srivastava ◽  
Deepak Shah

Introduction: Metabolic Syndrome (MetS) is characterised by the clustering of central obesity, hypertension, dyslipidemia, and hyperglycemia that predisposes patients to Cardiovascular Disease (CVD). It is a representative group of conditions with systemic inflammation, which is a potential mechanism responsible for both Chronic Obstructive Pulmonary Disease (COPD) and MetS. Aim: To detect incidence of MetS in COPD patients and its correlation with severity of COPD. Materials and Methods: The present study was an observational cross-sectional study which was conducted on 62 COPD patients in SS Hospital, BHU, Varanasi, Uttar Pradesh, India, from June 2015 to June 2017, diagnosed on basis of Global initiative for Lung Disease (GOLD) guidelines. 62 age and sex matched control having no cardio-respiratory history were included. All relevant investigations were done for all selected subjects and modified Medical Research Council (mMRC) dyspnoea grading was done in all the subjects. Standardised treatment modules were followed and spirometry and post-bronchodialater spirometry was performed 15-30 mins after inhalation of 400 mcg Salbutamol. Patients obstruction was classified according to the severity of airflow limitation based on post-bronchodilator Forced Expiratory Volume in one second (FEV1) as follows: mild (≥80% predicted); moderate (80>FEV1 ≥50% predicted); severe (50%> FEV1 ≥30% predicted); very severe (<30% predicted). Complete work-up and data collection were analysed by using Statistical Package for the Social Sciences (SPSS) version 23.0 software, descriptive cross tables, univariate and multivariate analysis. Independent Student’s t-test was used to compare the means of cases and controls. The p-value <0.05 was considered statistically significant. Results: Total 62 patients along with age and sex matched 62 healthy control in 1:1 ratio have been taken in the study, majority were in age group of 50-70 years. On comparing the mean values of different parametres of MetS in COPD cases and controls, significantly raised triglyceride level and fasting blood sugar in COPD cases (p-value <0.001 and 0.005 respectively) were observed. MetS was present in 29 cases (46.8%) of COPD whereas in healthy control population only 19 people (30.6%) were positive for MetS. Total of 55.2% cases of COPD with MetS was in group D whereas 84.8% cases of COPD without MetS were in group B of GOLD staging. Statistically significant (p<0.001) higher incidence of acute exacerbation was observed in cases of COPD with MetS. Conclusion: MetS was more prevalent among the COPD patient in 50-70 years age group with mild to moderate airflow limitation. More waist circumference i.e., central obesity, impaired fasting glucose, dyslipidemia, increases the risk of cardiovascular complication in these patients. MetS is an important co-morbidity in patients of COPD which fasten the natural course of disease by increasing the frequency of acute exacerbation.


Author(s):  
Melvin K Mathews ◽  
Abubaker Siddiq ◽  
Bharathi D R

Background: Chronic obstructive pulmonary disease (COPD) is preventable and treatable disease state characterized by air flow limitation that is not fully reversible. Severity of the symptoms is increased during exacerbations. Objectives: The purpose of the study is to assess and improve the knowledge regarding COPD among study subjects. Materials and Methods: A Cross-sectional interventional study was carried out among the peoples in selected areas of the Chitradurga city for a period of six months. Result: A total 207 subjects enrolled in the study in that 155 male and 52 females. In our study mean score of post test was more (5.87±1.68) when compare to pre-test (2.63±1.46) which show significant increase in their knowledge after educating them (p=0.000). A total of 207 subjects were enrolled into the study. SPSS Software was used to calculate the statistical estimation. Paired t-test was used to detect the association status of different variables. Conclusion: The relatively good level of COPD awareness needs to be maintained to facilitate future prevention and control of the disease. This study had identified that negative illness perceptions should be targeted, so that they will not avoid patients from seeking for COPD treatment and adhere to it. Key words: Cross sectional study, Knowledge, practice, COPD.


Author(s):  
Shashidhar Ramappa ◽  
Aishhwarrya Umeshchandra G. ◽  
Sheshan V. ◽  
Manigandan .

Background:COPD has been accepted as component of systemic inflammatory syndrome. Red cell distribution width (RDW) is a measure of coefficient of variation of mean corpuscular volume which increases in chronic systemic inflammation. The aim of the study was to evaluate the RDW as a predictor of severity of COPD using BODE index.Methods:In this cross-sectional study 107 COPD patients were evaluated by measuring RDW and this was correlated with the severity of disease using GOLD staging.Results:RDW correlates well with COPD patients. Significant correlation of RDW with BODE index (r=0.650, p and It; 0.001), gold staging (r=0.459, p and It; 0.001), 6MWT (r=0.697, p and It; 0.001) were observed.Conclusions: RDW was found to increase in patients with increasing severity of COPD. Hence its potential role as a marker of severity of disease and in predicting risk of cardiovascular disease can be explored.


2016 ◽  
Vol 23 (09) ◽  
pp. 1073-1078
Author(s):  
Atif Sitwat Hayat ◽  
Abdul Haque Khan ◽  
Ghulam Nabi Pathan ◽  
Mohammad Zubair Mushtaque

Objectives: Chronic obstructive pulmonary disease (COPD) leads to partialreversible obstruction of airways. The objective of our study is to determine frequency ofelevated C-reactive protein (CRP) level in patients of COPD at Liaquat University HospitalJamshoro/Hyderabad. Study Design: Cross-sectional study. Setting: Medical Unit-I of LiaquatUniversity Hospital Jamshoro/Hyderabad. Period: 1st March 2013 to 31st August 2013. Patientsand Methods: Patients of either sex and ages from 40-80 years old and having COPD for atleast two years duration were included. Patients below 40 years of age, having malignanciesor autoimmune disorders were excluded from this study. Results: We enrolled 186 patientswith COPD and their mean age was ± SD 57.63±8.45 years. Majority 182 (97.8%) had habitof smoking while 4(2.2%) were non-smokers. Mean CRP level in COPD patients was ± SD1.26±0.79 (range 0.1- 3.0 mg/d1). Out of 186 COPD patients, 94(50.6%) have raised CRP level(higher than 1.0 mg/dl). Median value of CRP level during this study was 1.10 mg/dl. About92(49.4%) patients have normal level of CRP (less than 1.0 mg/dl). Conclusion: On conclusion,frequency of raised C-reactive protein in our study was much higher (50.6%).


2020 ◽  
Vol 27 (2) ◽  
pp. 194-201
Author(s):  
Rilda Carla Alves de Souza ◽  
Fabíola Cássia de Oliveira Silva Vieira ◽  
Graziella Monicky Oliveira Costa ◽  
Kamila Roberta Perpétua de Souza ◽  
Laura Maria Gomes de Siqueira ◽  
...  

ABSTRACT This cross-sectional study assessed the activities of daily living (ADL) and risk factors for developing depressive symptoms in patients with chronic obstructive pulmonary disease (COPD) and was carried out at the pulmonology outpatient clinic of the Hospital Universitário Oswaldo Cruz. Two hundred two (202) patients with COPD participated in the study. We evaluated the sociodemographic and anthropometric data, the ADL by means of Pulmonary Functional Status and Dyspnea Questionnaire - Modified version (PFSDQ-M), and the presence of depressive symptoms using the Beck Depression Inventory (BDI). All domains (dyspnea, fatigue and activity changes) of PFSDQ are compromised in patients with depressive symptoms. The prevalence of depressive symptoms was 38.6%. The chance of developing these symptoms was higher for those who used more than one bronchodilator (OR: 2.82, CI 95%: 1.47-5.38, p=0.002), presented dyslipidemias (OR: 2.74, CI95%: 1.24-6.07, p=0.012), had a heart disease (OR: 2.82, CI 95%: 1.18-6.74, p=0.020), presented expectoration (OR: 2.44, CI 95%: 1.2-4.95, p=0.014) or did not have a partner (OR: 2.58, CI 95%: 1.36-4.9, p=0.004). COPD patients with depressive symptoms had all domains of ADL compromised compared to patients without these symptoms.


Author(s):  
Karthika M ◽  
Prakash Chandra Bhardwaj ◽  
Laimayum Amarnath Sharma ◽  
Laimayum Amarnath Sharma ◽  
W Kanan ◽  
...  

Abstract Patients with the chronic obstructive pulmonary disease have ongoing systemic inflammation, which can be assessed by measuring serum  C- reactive protein. Objective: To explore whether CRP could be used as an independent predictor of disease outcome in COPD. Methods: A cross-sectional study was conducted among 50 COPD patients attending Respiratory Medicine outpatient services in the Regional Institute of Medical Sciences (RIMS), Imphal from January 2015 to September 2016. Patients aged 18-67 were included in the study after obtaining Ethical approval from the Research Ethics Board, RIMS, Imphal. Computerized Spirometer Helios 401 was the instrument used to measure lung volumes and capacities. BeneSpheraTM CRP Latex Slide test kit was used to estimate serum c-reactive protein. Results and observation: The present study was conducted on fifty COPD patients in which serum CRP level showed positive correlation with COPD (p=0.002) but serum CRP level with spirometric parameters showed significant negative correlation;FEV1 (r=-0.451, p=0.001), FEV1/FVC (r=-0.617, p<0.001) and PEFR (r=-0.398, p=0.004). Conclusion: In our study, we found an association between serum CRP level and severity of COPD and Plasma CRP may be used as a marker of prognosis in COPD as the small increase is associated with poorer prognosis in COPD. Keywords: CRP; Chronic obstructive pulmonary disease (COPD); Imphal.


2020 ◽  
pp. 089719002093687
Author(s):  
Madison P. Lempp ◽  
Meredith A. Sigler ◽  
Adebola A. Adesoye ◽  
Anusha Ponnuru ◽  
Courtney E. Duval

Objective To determine if the use of inhaled corticosteroid (ICS) therapy affects glycemic control in patients with chronic obstructive pulmonary disease (COPD) and type 2 diabetes mellitus (T2DM). Background Studies have shown mixed evidence on the association between ICS use and worsening glycemic control in patients with preexisting diabetes. Methods Data were recorded from electronic medical records of veteran patients aged 18 to 80 with COPD and T2DM on at least 2 oral antiglycemic medications from January 1, 2000, to December 31, 2017, at the Veterans Affairs (VA) North Texas Health Care System (VANTHCS). The primary outcome was the rate of A1c progression >10% at 12 months and 5 years. Results This study included 127 (64 in the ICS group and 63 in the non-ICS group) patients; baseline characteristics between groups were similar with the exception of age and tobacco use. No statistically significant difference was found between groups with regard to the primary outcome. More patients in the non-ICS group had antiglycemic medications initiated at 12 months ( P = .009) and 5 years ( P = .003) compared to the ICS group. Conclusion Inhaled corticosteroids did not negatively impact glycemic control among veterans with comorbid COPD and T2DM.


2021 ◽  
Vol 31 (1) ◽  
Author(s):  
Johanna Sulku ◽  
Kristina Bröms ◽  
Marieann Högman ◽  
Christer Janson ◽  
Karin Lisspers ◽  
...  

AbstractA correct use of inhaler devices is essential in chronic obstructive pulmonary disease (COPD) treatment. Critical errors were studied by analysing 659 video-recorded demonstrations of inhaler technique from 364 COPD patients using six different inhaler device models. The majority of the included patients used two (55%) or more (20%) device models. Overall, 66% of the patients made ≥1 critical error with at least one device model. The corresponding numbers for patients using 1, 2 and ≥3 device models were 43%, 70% and 86%, respectively. The only factor associated with making ≥1 critical error was simultaneous use of two (adjusted odds ratios (aOR) 3.17, 95% confidence interval (95% CI) 1.81, 5.64) or three or more (aOR 8.97, 95% CI 3.93, 22.1) device models. In conclusion, the proportion of patients making critical errors in inhaler technique was substantial, particularly in those using several different device models. To obtain optimal COPD treatment, it is important to assess a patient’s inhaler technique and to minimise the number of inhaler device models.


2021 ◽  
Vol 31 (1) ◽  
Author(s):  
Heling Bao ◽  
Guohua Jia ◽  
Shu Cong ◽  
Wanlu Sun ◽  
Jing Fan ◽  
...  

AbstractThis study aims to investigate the characteristics of the phenotype and management of chronic obstructive pulmonary disease (COPD) patients in the general population in China. We analyzed spirometry-confirmed COPD patients who were identified from a population-based, nationally representative sample in China. All participants were measured with airflow limitation severity based on post-bronchodilator FEV1 percent predicted, bronchodilator responsiveness, exacerbation history, and respiratory symptoms. Among a total of 9134 COPD patients, 90.3% were non-exacerbators, 2.9% were frequent exacerbators without chronic bronchitis, 2.0% were frequent exacerbators with chronic bronchitis, and 4.8% were asthma-COPD overlap. Less than 5% of non-exacerbators ever had pulmonary function testing performed. The utilization rate of inhaled medication in non-exacerbators, exacerbators without chronic bronchitis, exacerbators with chronic bronchitis, and asthma-COPD overlap was 1.4, 23.5, 29.5, and 19.4%, respectively. A comprehensive strategy for the management of COPD patients based on phenotype in primary care is urgently needed.


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