Open AccessGlycated hemoglobin A1c-based adjusted glycemic variables in patients with diabetes presenting with acute exacerbation of chronic obstructive pulmonary disease
Author(s) -
ChangHao Yang,
Wen I. Liao,
Zun Cheng Tang,
Jen-Chun Wang,
Chien Hsing Lee,
Wen Han Chang,
Chin Wang Hsu,
Shih En Tang
Publication year - 2017
Publication title -
international journal of chronic obstructive pulmonary disease/international journal of copd
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.394
H-Index - 67
eISSN - 1178-2005
pISSN - 1176-9106
DOI - 10.2147/copd.s131232
Subject(s) - medicine , glycated hemoglobin , glycemic , copd , diabetes mellitus , exacerbation , stress hyperglycemia , acute exacerbation of chronic obstructive pulmonary disease , type 2 diabetes , intensive care medicine , insulin , endocrinology
Acute hyperglycemia is a common finding in patients presenting to emergency departments (EDs) with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Several studies have argued against the association between hyperglycemia at admission and adverse outcomes in patients with diabetes and an acute illness. Recent studies have shown that glucose-related variables (eg, glycemic gaps and stress hyperglycemia ratios) that are adjusted for glycated hemoglobin levels can indicate the severity of a variety of diseases. The objective of this study was to assess whether these hemoglobin A1c (HbA1c)-based adjusted average glycemic variables were associated with unfavorable outcomes in patients admitted to a hospital with AECOPD. We found that 1) pulmonary infection is a major risk factor for AECOPD; 2) a higher glycemic gap and modified stress hyperglycemia ratio were associated with the development of acute respiratory failure (ARF) in patients with diabetes admitted to an ED because of AECOPD; and 3) the glycemic gap and modified stress hyperglycemia ratio had superior discriminative power over acute hyperglycemia and HbA1c for predicting the development of ARF, although the HbA1c-adjusted glycemic variables alone were not independent risk factors for ARF.