Use of inhaled corticosteroids and the risk of developing type 2 diabetes in patients with chronic obstructive pulmonary disease

Mohamad Isam Saeed, Josefin Eklöf, Imane Achir, Pradeesh Sivapalan, Howraman Meteran, Anders Løkke, Tor Biering-Sørensen, Filip Krag Knop, Jens-Ulrik Staehr Jensen

Publikation: Bidrag til tidsskriftArtikelForskningpeer review

Abstract

AIM: To determine the risk of type 2 diabetes onset associated with accumulated inhaled corticosteroids (ICS) dose during the previous year in patients with chronic obstructive pulmonary disease (COPD).

MATERIALS AND METHODS: We conducted a nationwide observational cohort study based on data from patients with COPD between 1 January 2010 and 31 December 2017 extracted from Danish health databases. Patients were followed for 7 years, until death or a type 2 diabetes event. A propensity-matched Cox model and an adjusted Cox proportional hazards model (stratified on body mass index [BMI]) were used to estimate the hazard ratio (HR) for new-onset type 2 diabetes.

RESULTS: A total of 50 148 patients with COPD were included, 3566 (7.1%) of whom had a type 2 diabetes event. During the previous year before study entry, 35 368 patients (70.5%) used ICS. The propensity-matched Cox model (N = 33 466) showed an increased risk of type 2 diabetes, which progressed with increasing accumulated ICS dose (low-ICS: HR 1.076, confidence interval [CI] 1.075-1.077, P < .0001; medium-ICS: HR 1.106, CI 1.105-1.108, P < .0001; high-ICS: HR 1.150, CI 1.148-1.151, P < .0001), compared with no ICS use. Results were confirmed in the adjusted Cox analysis on the entire study population, but only for patients with BMI <30 kg/m2 .

CONCLUSIONS: In patients with COPD, ICS use was associated with a moderate dose-dependent increase in the occurrence of type 2 diabetes.

OriginalsprogEngelsk
Sider (fra-til)1348-1356
Antal sider9
TidsskriftDiabetes, Obesity and Metabolism
Vol/bind22
Udgave nummer8
DOI
StatusUdgivet - aug. 2020

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© 2020 John Wiley & Sons Ltd.

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