Features, risk factors and prognosis of hyperglycemia in patients with obstructive pulmonary diseases

Purpose. Studying features and risk factors of hyperglycemia in patients with obstructive pulmonary diseases. Materials and methods. Retrospective analysis of 93 cases of patients (68 women and 25 men aged 68,6±10,2, with 12,2±7,5 year disease duration) undergoing in-patient treatment of exacerbations of asthma and chronic obstructive pulmonary disease was carried out. The patients were segregated into 2 groups on the basis of their age, sex and pulmonary disease duration: 1 group - 35 cases of patients with chronic obstructive pulmonary diseases and type 2 diabetes mellitus, 2 group - 30 cases of patients with chronic obstructive pulmonary diseases without carbohydrate metabolism disorders. In both the groups the presence of chronic diseases was evaluated, and modified Charlson comorbidity index (in points) was calculated, in the 1st group - glycemia dynamics before and after eating (for 3 years) was measured, and risk factors of its development were evaluated. Results and conclusions. A high incidence of various comorbid conditions in group 1 and 2 with prevailing cardiovascular morbidity and diseases caused by metabolic disorders was revealed. The group of patients with chronic obstructive pulmonary diseases and type 2 diabetes mellitus tended to demonstrate a high incidence of comorbid conditions. Hyperglycemia case follow-up revealed risk factors for diabetes mellitus development were revealed: the presence of certain clinical phenotypes of the disease (overlap syndrome of asthma and obesity), broncho-obstructive syndrome manifestations, frequent hospitalizations and the use of systemic glucocorticosteroids in the treatment. It is the first time when hyperglycemia revealed in patients with obstructive pulmonary diseases can be regarded as a marker of early carbohydrate metabolism disorders requiring supervision and regular monitoring.