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Diabetes risks and outcomes in chronic obstructive pulmonary disease patients: Two nationwide population-based retrospective cohort studies.
PLoS One 2017; 12(8):e0181815Plos

Abstract

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.

Authors+Show Affiliations

Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University Hospital, Taipei, Taiwan. Anesthesiology and Health Policy Research Center, Taipei Medical University Hospital, Taipei, Taiwan. Department of Anesthesiology, Taipei Medical University, Taipei, Taiwan.Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University Hospital, Taipei, Taiwan. Anesthesiology and Health Policy Research Center, Taipei Medical University Hospital, Taipei, Taiwan. Department of Anesthesiology, Taipei Medical University, Taipei, Taiwan.Department of Surgery, China Medical University Hospital, Taichung, Taiwan. Department of Surgery, University of Illinois, Chicago, United States of America.Division of Endocrinology, Department of Medicine, National Taiwan University Hospital, Taipei, Taiwan.Division of Pulmonary Medicine, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan.School of Chinese Medicine for Post-Baccalaureate, College of Medicine, I-Shou University, Kaohsiung, Taiwan.School of Chinese Medicine for Post-Baccalaureate, College of Medicine, I-Shou University, Kaohsiung, Taiwan.Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University Hospital, Taipei, Taiwan. Anesthesiology and Health Policy Research Center, Taipei Medical University Hospital, Taipei, Taiwan. Department of Anesthesiology, Taipei Medical University, Taipei, Taiwan.Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University Hospital, Taipei, Taiwan. Anesthesiology and Health Policy Research Center, Taipei Medical University Hospital, Taipei, Taiwan. Department of Anesthesiology, Taipei Medical University, Taipei, Taiwan. School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan. Department of Anesthesiology, Shuan Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28813433

Citation

Lin, Chao-Shun, et al. "Diabetes Risks and Outcomes in Chronic Obstructive Pulmonary Disease Patients: Two Nationwide Population-based Retrospective Cohort Studies." PloS One, vol. 12, no. 8, 2017, pp. e0181815.
Lin CS, Liu CC, Yeh CC, et al. Diabetes risks and outcomes in chronic obstructive pulmonary disease patients: Two nationwide population-based retrospective cohort studies. PLoS ONE. 2017;12(8):e0181815.
Lin, C. S., Liu, C. C., Yeh, C. C., Chang, Y. C., Chung, C. L., Lane, H. L., ... Liao, C. C. (2017). Diabetes risks and outcomes in chronic obstructive pulmonary disease patients: Two nationwide population-based retrospective cohort studies. PloS One, 12(8), pp. e0181815. doi:10.1371/journal.pone.0181815.
Lin CS, et al. Diabetes Risks and Outcomes in Chronic Obstructive Pulmonary Disease Patients: Two Nationwide Population-based Retrospective Cohort Studies. PLoS ONE. 2017;12(8):e0181815. PubMed PMID: 28813433.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Diabetes risks and outcomes in chronic obstructive pulmonary disease patients: 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, Y1 - 2017/08/16/ PY - 2017/01/24/received PY - 2017/07/05/accepted PY - 2017/8/17/entrez PY - 2017/8/17/pubmed PY - 2017/10/19/medline SP - e0181815 EP - e0181815 JF - PloS one JO - PLoS ONE VL - 12 IS - 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. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/28813433/Diabetes_risks_and_outcomes_in_chronic_obstructive_pulmonary_disease_patients:_Two_nationwide_population_based_retrospective_cohort_studies_ L2 - http://dx.plos.org/10.1371/journal.pone.0181815 DB - PRIME DP - Unbound Medicine ER -