Diabetes mellitus type 2 (T2D) as a comorbidity of Chronic Obstructive Pulmonary Disease (COPD)

Abstract

We aimed to investigate the association between COPD and T2D and the relation to the severity of airflow limitation. Cross-sectional study including 120 patients with initially diagnosed COPD, aged 40 to 75 years and 60 nonCOPD subjects matched by age, smoking status, body mass index, as controls. All study participants underwent anthropometric measurements, fasting blood sugar (FBS), oral glucose tolerance test (OGTT) (performed in patients with fasting blood sugar level 5.6- 6.1mmol/L (measured two times), lipid profile, CRP, pulmonary evaluation (dyspnea severity assessment, baseline and post-bronchodilator spirometry, gas analyses, chest X-ray). Results presented statistically significant difference in presence of T2D in COPD patients compared to controls (45.0% vs 20.0%; P=0.0011). According to the GOLD classification, the frequencies of T2D in COPD patients were categorized in stages I, II, III, IV (25.0%, 43.3%, 52.5%, 58.3%, respectively), and according to combined assessment test in A, B, C, D (29.2%, 37.5%, 35.0%, 41.7% respectively). In GOLD 2 stage the risk for T2D was 2.3 times higher than GOLD1. COPD patients with T2D presented significant association with pulmonary function. FBS was higher in COPD than controls (8.4±1.1mmol/L vs 4.9±2.1mmol/L) with statistical significance (p<0.0001), but HDL was lower in COPD than controls (39.1±6.4mg/dl vs 49.6±3.9mg/dl) with statistical significance (p<0.0001).We found higher prevalence of T2D in patients with COPD even in early COPD stages compared to nonCOPD. Our findings suggest multidisciplinary approach in COPD patients for prevention, diagnosis and early start of treatment.