TY - JOUR
T1 - Diabetes risks and outcomes in chronic obstructive pulmonary disease patients
T2 - Two nationwide population-based retrospective cohort studies
AU - Lin, Chao Shun
AU - Liu, Chih Chung
AU - Yeh, Chun Chieh
AU - Chang, Yi Cheng
AU - Chung, Chi Li
AU - Lane, Hsin Long
AU - Shih, Chun Chuan
AU - Chen, Ta Liang
AU - Liao, Chien Chang
N1 - Funding Information:
This research was supported in part by Shuang Ho Hospital, Taipei Medical University (104TMU-SHH-23), Taipei Medical University (TMU101-AE1-B33), and Taiwan's Ministry of Science and Technology (MOST106-2221-E-038-003; 106-2314-B-038-036-MY3; MOST105-2629-B-038-001; MOST105-2314-B-038-025; MOST105-2221-E-038-014; MOST104-2221-E-038-015; MOST104-2314-B-038-027-MY2; NSC102-2314-B-038-021-MY3)
PY - 2017/8
Y1 - 2017/8
N2 - OBJECTIVE: The relationship between chronic obstructive pulmonary disease (COPD) and diabetes remains incompletely understood. This study evaluated diabetes risk and post-diabetes outcomes in COPD patients with and without exacerbations.METHODS: We identified 4671 adults newly diagnosed with COPD exacerbations and 9342 adults newly diagnosed with COPD without exacerbations during 2000-2008 using Taiwan's National Health Insurance Research Database. A comparison cohort of 18684 adults without COPD, matched by age and sex, was randomly selected from the same dataset for the control group. Diabetes events during 2000-2013 were ascertained from medical claims during the follow-up period. Adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of diabetes associated with COPD with or without exacerbations were calculated. We conducted another nested cohort study of 395516 patients with diabetes hospitalization during 2002-2013 and calculated adjusted odds ratios (ORs) and 95% CIs of histories of COPD and COPD exacerbations associated with adverse events after diabetes admission.RESULTS: During the follow-up period, the incidences of diabetes for patients without COPD and for patients with COPD without or with exacerbations were 3.4, 4.1 and 7.4 per 1000 person-years, respectively (P < 0.0001). Increased risk of diabetes for patients with COPD without exacerbations (HR 1.09, 95% CI 1.02-1.17) and COPD with exacerbations (HR 2.18, 95% CI 1.88-2.52) was noted. Post-diabetes pneumonia (OR 3.28, 95% CI 3.13-3.43), intensive care admission (OR 1.32, 95% CI 1.26-1.39) and mortality (OR 2.06, 95% CI 1.88-2.25) were associated with COPD exacerbations.CONCLUSION: Prevention and intervention strategies for diabetes and post-diabetes outcomes are needed for this susceptible population.
AB - OBJECTIVE: The relationship between chronic obstructive pulmonary disease (COPD) and diabetes remains incompletely understood. This study evaluated diabetes risk and post-diabetes outcomes in COPD patients with and without exacerbations.METHODS: We identified 4671 adults newly diagnosed with COPD exacerbations and 9342 adults newly diagnosed with COPD without exacerbations during 2000-2008 using Taiwan's National Health Insurance Research Database. A comparison cohort of 18684 adults without COPD, matched by age and sex, was randomly selected from the same dataset for the control group. Diabetes events during 2000-2013 were ascertained from medical claims during the follow-up period. Adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of diabetes associated with COPD with or without exacerbations were calculated. We conducted another nested cohort study of 395516 patients with diabetes hospitalization during 2002-2013 and calculated adjusted odds ratios (ORs) and 95% CIs of histories of COPD and COPD exacerbations associated with adverse events after diabetes admission.RESULTS: During the follow-up period, the incidences of diabetes for patients without COPD and for patients with COPD without or with exacerbations were 3.4, 4.1 and 7.4 per 1000 person-years, respectively (P < 0.0001). Increased risk of diabetes for patients with COPD without exacerbations (HR 1.09, 95% CI 1.02-1.17) and COPD with exacerbations (HR 2.18, 95% CI 1.88-2.52) was noted. Post-diabetes pneumonia (OR 3.28, 95% CI 3.13-3.43), intensive care admission (OR 1.32, 95% CI 1.26-1.39) and mortality (OR 2.06, 95% CI 1.88-2.25) were associated with COPD exacerbations.CONCLUSION: Prevention and intervention strategies for diabetes and post-diabetes outcomes are needed for this susceptible population.
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U2 - 10.1371/journal.pone.0181815
DO - 10.1371/journal.pone.0181815
M3 - Article
C2 - 28813433
AN - SCOPUS:85031781188
SN - 1932-6203
VL - 12
JO - PLoS ONE
JF - PLoS ONE
IS - 8
M1 - e0181815
ER -