Glycated hemoglobin A1c-based adjusted glycemic variables in patients with diabetes presenting with acute exacerbation of chronic obstructive pulmonary disease

Chih Jen Yang, Wen I. Liao, Zun Cheng Tang, Jen Chun Wang, Chien Hsing Lee, Wei Chou Chang, Chin Wang Hsu, Shih En Tang, Shih Hung Tsai

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)1923-1932
Number of pages10
JournalInternational Journal of COPD
Volume12
DOIs
Publication statusPublished - Jul 3 2017

Keywords

  • Acute respiratory failure
  • Chronic obstructive pulmonary disease
  • Diabetes mellitus
  • Glycated hemoglobin
  • Glycemic gap
  • Hyperglycemia
  • Stress hyperglycemia ratio

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Health Policy
  • Public Health, Environmental and Occupational Health

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