10Feb 2018

EFFECT OF HYPERGLYCEMIA ON OUTCOME OF ACUTE EXACERBATION OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE.

  • Associate professor, Department of medicine, KGMU.
  • Junior resident III, Department of medicine, KGMU.
  • Professor junior grade, Department of medicine, KGMU.
  • Professor, Department of medicine, KGMU.
  • Associate professor, Department of medicine, KGMU.
  • Senior resident, Department of medicine, KGMU.
Crossref Cited-by Linking logo

  • Abstract
  • References
  • Cite This Article as
  • Corresponding Author

Introduction : The Global Initiative for Chronic Obstructive Lung Disease (GOLD) recently defined COPD as “Chronic Obstructive Pulmonary Disease (COPD) as a common, preventable and treatable disease that is characterized by persistent respiratory symptoms and airflow limitation that is due to airway and/or alveolar abnormalities usually caused by significant exposure to noxious particles or gases”. Hyperglycemia has been associated with increased morbidity, increased mortality, and longer lengths of stay, and more hospital costs in patients with both medical and surgical conditions. Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is associated with hyperglycemia due to the stress related hormonal response to acute illness and possibly some of the medications routinely used in the treatment of AECOPD. Aim: To study the effect of hyperglycemia on outcome of acute exacerbation of COPD and to compare the mean duration of hospital stay in acute exacerbation of COPD patients divided in to groups according to severity of hyperglycemia and HbA1C levels. Materials and Methods : This was a Prospective study done in KGMU, Lucknow. The study group comprised of COPD patients and admitted as acute exacerbation of COPD and severity was determined according to GOLD classification criteria, and their hospital stay was correlated with RBS and HbA1c. Results: A total of 107 patients of COPD were enrolled in the study of which 6 patients died. 101 patients underwent the follow up study. Duration of hospital stay among patients having RBS> 200 mg/dl was (9.63±2.04 days) and was found to be statistically significant to patients whose RBS was <200 mg/dl (6.89±2.08 days). Similar results were seen with pateints having HBA1c >6 and < 6. Conclusion: Strict control of blood sugar, in the pre hospitalization period as well as during hospital stay results in better outcomes and also shortened hospital stay; thus influencing both mortality and morbidity.

  1. Global Initiative for Chronic Obstructive Lung Disease (GOLD) Global strategy for the diagnosis, management, and prevention of COPD (revised 2017).
  2. Capes S, Hunt D, Malmberg K, Pathak P, Gerstein H. Stress Hyperglycemia and Prognosis of Stroke in Nondiabetic and Diabetic Patients: A Systematic Overview. Stroke. 2001;32(10):2426-2432
  3. Capes S, Hunt D, Malmberg K, Pathak P, Gerstein H. Stress Hyperglycemia and Prognosis of Stroke in Nondiabetic and Diabetic Patients: A Systematic Overview. Stroke. 2001;32(10):2426-2432
  4. Umpierrez G, Isaacs S, Bazargan N, You X, Thaler L, Kitabchi A. Hyperglycemia: An Independent Marker of In-Hospital Mortality in Patients with Undiagnosed Diabetes. The Journal of Clinical Endocrinology & Metabolism. 2002;87(3):978-982
  5. Devi P,Goornavar SM,Kanumuri R. Correlation of blood glucose levels on the outcome of patients with acute exacerbation of chronic obstructive pulmonary disease. Indian Journal Of Applied Medical Research. 2016 March;5(2)?:103-112.
  6. R Castellanos M, Szerszen A, Saifan C, Zigelboym I, Khoueiry G, Abi Rafeh N. Fasting hyperglycemia upon hospital admission is associated with higher pneumonia complication rates among the elderly. International Archives of Medicine. 2010
  7. The association between blood glucose levels and hospital outcomes in patients admitted with acute exacerbations of chronic obstructive pulmonary disease. The Southwest Respiratory and Critical Care Chronicles. 2014;2(7).
  8. Nugent K, Islam E, Limsuwat C, Nantsupawat T, Berdine G. The association between glucose levels and hospital outcomes in patients with acute exacerbations of chronic obstructive pulmonary disease. Annals of Thoracic Medicine. 2015;10(2):94
  9. Kamdar D, Patel D. A prospective study of the predictors of mortality in acute exacerbation of COPD: an Indian perspective. International Journal of Advances in Medicine. 2017;4(2):362.

[Kamlesh Kumar Gupta, Vinod Kumar, Shyam chand Chaudhary, Arvind Mishra, Munna Lal Patel and Bidyut Roy. (2018); EFFECT OF HYPERGLYCEMIA ON OUTCOME OF ACUTE EXACERBATION OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE. Int. J. of Adv. Res. 6 (Feb). 929-933] (ISSN 2320-5407). www.journalijar.com

Dr Vinod Kumar
junior resident III

DOI:

Article DOI: 10.21474/IJAR01/6513      
DOI URL: https://dx.doi.org/10.21474/IJAR01/6513

Download Full Paper

Download PDF No. of Downloads: 93 | No. of Views: 256