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Thursday, September 30, 2010

Diabetes might make COPD worse

A recent study performed by researchers at Liverpool Hospital in Australia has discovered that people suffering from diabetes, who are admitted to the hospital with exacerbation of COPD, have to stay in the hospital longer, and have a greater chance of dying.

According to this article from, researchers say this might be because "that this may be because mutilation of their immune response owing to high blood sugar might lead to more austere contagions."

Of course not mentioned in this article is that systemic corticosteroids given in an attempt to reduce airway inflammation has the side effect of throwing glucose out of whack. This is one of the reasons why COPD patients admitted to the hospital will often have to have their sugar checked on a regular basis.

I recently wrote about another study that showed that COPD patients who were treated with oral corticosteroids instead of systemic corticosteroids were more likely to have a shorter length of stay in the hospital.

One would wonder if these two studies might correlate to a future where systemic corticosteroids are not used so much for COPD exacerbations to not only reduce lenth of stay, but reduce mortality, especially pertaining to COPD patients with diabetes.

Along with a reduction in systemic corticosteroids, improved control of diabetes might also work to reduce COPD related morbidity and mortality. Althought the key here might be improved patient compliance and education, and improved doctor involvement in patient care.

As I wrote before, however, changing the current protocols seems to be a problem among hospitals and physicians. Even if the the GOLD initiative for COPD guidelines change, it's still tough to get doctors educated prior to the release of new guidelines to change their own policy.

So, in leu of upcoming studies, I imagine we might see some major changes in the COPD protocols in the years to come.

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