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

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.