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An Association Between Different Doses of Inhaled Corticosteroids and Glycaemic Status in Patients with Chronic Obstructive Pulmonary Disease

Received: 3 October 2020     Accepted: 31 August 2021     Published: 12 October 2021
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Abstract

Introduction: Inhaled corticosteroids effective medications for the treatment of asthma. Higher doses of inhaled fluticasone (1000 μgm / day) are commonly used in COPD. Such high doses have been associate with significant systemic effects such as pneumonia, glaucoma, cataracts, adrenal suppression and accelerated bone turnover. Aim of the study: The aim of the study was to evaluate the association between different doses of inhaled corticosteroids (Fluticasone Propionate µgm / day) and glycaemic status in Patients with Chronic Obstructive Pulmonary Disease. Material & Methods: This was a cross-sectional analytical study. This study was conducted at the department of Internal Medicine in Bangobandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, during May, 2016-April, 2017. The protocol of this study was approved by IRB and ethical committee. A total of 80 patients with COPD were included in this study, of them clinically diagnosed 40 consecutive COPD patients who were receiving both bronchodilator & inhaled corticosteroids were recruited as case group and clinically diagnosed 40 consecutive COPD patients receiving only bronchodilator without inhaled corticosteroid/systemic steroid were recruited as control, group. Spirometry was done for confirmation and staging of COPD according to GOLD at indoor and OPD patients of Department of Internal Medicine, BSMMU. Results: In case group, the inhaled corticosteroid dose (5000) was counted 02 (5%) and the mean of FPG value was 6.25±1.34, the inhaled corticosteroid dose (1000) was counted 27 (67.5%) and the mean of FPG value was 5.7±1.58, the inhaled corticosteroid dose (2000) was counted 11 (27.5%) and the mean of FPG value was 6.58±2.24. The total FPG mean of the doses was 5.97±1.78. Among case group according to inhaled corticosteroid dose in case group, the inhaled corticosteroid dose (500) was counted 02 (5%) and the mean of 2HABF value was 9.65±3.18, the inhaled corticosteroid dose (1000) was counted 27 (67.5%) and the mean of 2HABF value was 8.71±2.84, the inhaled corticosteroid dose (2000) was counted 11 (27.5%) and the mean of 2HABF value was 9.51±2.9. The total mean of 2HABF value of the doses was 8.98±2.82. In case group, the inhaled corticosteroid dose (500) was counted 02 (5%) and the mean of HbA1C value was 5.85±1.06, the inhaled corticosteroid dose (1000) was counted 27 (67.5%) and the mean of HbA1C value was 6.07±0.7, the inhaled corticosteroid dose (2000) was counted 11 (27.5%) and the mean of HbA1C value was 6.7±0.74. The total mean of HbA1C value of the doses was 6.23±0.77. Conclusion: We had found that 32% of cases and 7.5% of control group were diagnosed as diabetic when fasting plasma glucose taken into account, while in case of 2 hours after breakfast plasma sugar the number were 32.5% and 10% respectively and in case of HbA1c the number were 23.5% and 10% respectively.

Published in American Journal of Internal Medicine (Volume 9, Issue 5)
DOI 10.11648/j.ajim.20210905.14
Page(s) 236-243
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

Inhaled Corticosteroids, Glycaemic Status, COPD, Inhaled Corticosteroid Dose

References
[1] Postma DS and Calverley P., 2009. Inhaled corticosteroids in COPD: a case in favour. European Respiratory Journal, 34, 10-12.
[2] Rabe et al., 2007. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. American Journal of Respiratory Critical Care Medicine, 176, 532–55.
[3] Corrado A and Rossi A., 2012. How far is real life from COPD therapy guidelines? An Italian observational study. Respiratory Medicine 106, 989–97.
[4] Wedzicha JA et al., 2008. The prevention of chronic obstructive pulmonary disease exacerbations by salmeterol/fluticasone propionate or tiotropium bromide. American Journal of Respiratory Critical Care Medicine, 177, 19–26.
[5] Garbe E. et al (2007) Systematic Review: Agranulocytosis Induced by Nonchemotherapy Drugs, Annals of Internal Medicine, 146 (9): 657-65.
[6] Mannino DM et al., 2008. Prevalence and outcomes of diabetes, hypertension and cardiovascular disease in COPD. European Respiratory Journal, 32, 962-9.
[7] Calverley PM et al (2007), A Pooled Analysis of FEV1 Decline in COPD Patients Randomized to Inhaled Corticosteroids or Placebo, 131 (3): 682-689.
[8] Slatore, Christopher G., Chris L. Bryson, and David H. Au. "The association of inhaled corticosteroid use with serum glucose concentration in a large cohort." The American journal of medicine 122.5 (2009): 472-478.
[9] Faul et al: The effect of an inhaled corticosteroid on glucose control in type 2 diabetes. Clinical Med Res 2009; 7: 14-20.
[10] Suissa S, Kezouh A and Ernst P., 2010. Inhaled corticosteroids and the risks of diabetes onset and progression. American Journal of Medicine, 123, 1001e6.
[11] Matthijnssens, Jelle, et al. "Higher proportion of G2P [4] rotaviruses in vaccinated hospitalized cases compared with unvaccinated hospitalized cases, despite high vaccine effectiveness against heterotypic G2P [4] rotaviruses." Clinical Microbiology and Infection 20.10 (2014): O702-O710.
[12] Faul et al (2002), Alterations in Airway Inflammation and Lung Function during Corticosteroid Therapy for Atopic Asthma. The Chest-121: 1414-1420.
[13] Mirrakhimov, et al. Chronic obstructive pulmonary disease and glucose metabolism: a bitter sweet symphony. Cardiovasc Diabetol 11, 132 (2012). https://doi.org/10.1186/1475-2840-11-132
[14] Rana J et al., 2004. Pulmonary disease, asthma, and risk of type 2 diabetes in women. Diabetes Care, 27, 2478–84.
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[16] Christopher et al. (2015), Association of COPD with risk for pulmonary infections requiring hospitalization in HIV-infected Veterans, PMC (2015): 70 (3): 280-288.
[17] Dendukuri et al, Metabolic Effects Associated with ICS in Patients with COPD and Comorbid Type 2 Diabetes: A Historical Matched Cohort Study, POLOS ONE: 11 (19), 2016: e0162903.
Cite This Article
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    Mohammad Abul Kalam Azad Khan, Kabirul Hasan Bin Rakib, Md. Saiful Islam Patwary, Mohammad Mahmudur Rahman Chowdhury, Abu Salah Mohammamed Sirajum Munir, et al. (2021). An Association Between Different Doses of Inhaled Corticosteroids and Glycaemic Status in Patients with Chronic Obstructive Pulmonary Disease. American Journal of Internal Medicine, 9(5), 236-243. https://doi.org/10.11648/j.ajim.20210905.14

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    ACS Style

    Mohammad Abul Kalam Azad Khan; Kabirul Hasan Bin Rakib; Md. Saiful Islam Patwary; Mohammad Mahmudur Rahman Chowdhury; Abu Salah Mohammamed Sirajum Munir, et al. An Association Between Different Doses of Inhaled Corticosteroids and Glycaemic Status in Patients with Chronic Obstructive Pulmonary Disease. Am. J. Intern. Med. 2021, 9(5), 236-243. doi: 10.11648/j.ajim.20210905.14

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    AMA Style

    Mohammad Abul Kalam Azad Khan, Kabirul Hasan Bin Rakib, Md. Saiful Islam Patwary, Mohammad Mahmudur Rahman Chowdhury, Abu Salah Mohammamed Sirajum Munir, et al. An Association Between Different Doses of Inhaled Corticosteroids and Glycaemic Status in Patients with Chronic Obstructive Pulmonary Disease. Am J Intern Med. 2021;9(5):236-243. doi: 10.11648/j.ajim.20210905.14

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  • @article{10.11648/j.ajim.20210905.14,
      author = {Mohammad Abul Kalam Azad Khan and Kabirul Hasan Bin Rakib and Md. Saiful Islam Patwary and Mohammad Mahmudur Rahman Chowdhury and Abu Salah Mohammamed Sirajum Munir and Sohel Ahmed and Mohammad Ashif Iqbal and Mohammad Mushahidul Islam and Md. Abdur Rahim},
      title = {An Association Between Different Doses of Inhaled Corticosteroids and Glycaemic Status in Patients with Chronic Obstructive Pulmonary Disease},
      journal = {American Journal of Internal Medicine},
      volume = {9},
      number = {5},
      pages = {236-243},
      doi = {10.11648/j.ajim.20210905.14},
      url = {https://doi.org/10.11648/j.ajim.20210905.14},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajim.20210905.14},
      abstract = {Introduction: Inhaled corticosteroids effective medications for the treatment of asthma. Higher doses of inhaled fluticasone (1000 μgm / day) are commonly used in COPD. Such high doses have been associate with significant systemic effects such as pneumonia, glaucoma, cataracts, adrenal suppression and accelerated bone turnover. Aim of the study: The aim of the study was to evaluate the association between different doses of inhaled corticosteroids (Fluticasone Propionate µgm / day) and glycaemic status in Patients with Chronic Obstructive Pulmonary Disease. Material & Methods: This was a cross-sectional analytical study. This study was conducted at the department of Internal Medicine in Bangobandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, during May, 2016-April, 2017. The protocol of this study was approved by IRB and ethical committee. A total of 80 patients with COPD were included in this study, of them clinically diagnosed 40 consecutive COPD patients who were receiving both bronchodilator & inhaled corticosteroids were recruited as case group and clinically diagnosed 40 consecutive COPD patients receiving only bronchodilator without inhaled corticosteroid/systemic steroid were recruited as control, group. Spirometry was done for confirmation and staging of COPD according to GOLD at indoor and OPD patients of Department of Internal Medicine, BSMMU. Results: In case group, the inhaled corticosteroid dose (5000) was counted 02 (5%) and the mean of FPG value was 6.25±1.34, the inhaled corticosteroid dose (1000) was counted 27 (67.5%) and the mean of FPG value was 5.7±1.58, the inhaled corticosteroid dose (2000) was counted 11 (27.5%) and the mean of FPG value was 6.58±2.24. The total FPG mean of the doses was 5.97±1.78. Among case group according to inhaled corticosteroid dose in case group, the inhaled corticosteroid dose (500) was counted 02 (5%) and the mean of 2HABF value was 9.65±3.18, the inhaled corticosteroid dose (1000) was counted 27 (67.5%) and the mean of 2HABF value was 8.71±2.84, the inhaled corticosteroid dose (2000) was counted 11 (27.5%) and the mean of 2HABF value was 9.51±2.9. The total mean of 2HABF value of the doses was 8.98±2.82. In case group, the inhaled corticosteroid dose (500) was counted 02 (5%) and the mean of HbA1C value was 5.85±1.06, the inhaled corticosteroid dose (1000) was counted 27 (67.5%) and the mean of HbA1C value was 6.07±0.7, the inhaled corticosteroid dose (2000) was counted 11 (27.5%) and the mean of HbA1C value was 6.7±0.74. The total mean of HbA1C value of the doses was 6.23±0.77. Conclusion: We had found that 32% of cases and 7.5% of control group were diagnosed as diabetic when fasting plasma glucose taken into account, while in case of 2 hours after breakfast plasma sugar the number were 32.5% and 10% respectively and in case of HbA1c the number were 23.5% and 10% respectively.},
     year = {2021}
    }
    

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  • TY  - JOUR
    T1  - An Association Between Different Doses of Inhaled Corticosteroids and Glycaemic Status in Patients with Chronic Obstructive Pulmonary Disease
    AU  - Mohammad Abul Kalam Azad Khan
    AU  - Kabirul Hasan Bin Rakib
    AU  - Md. Saiful Islam Patwary
    AU  - Mohammad Mahmudur Rahman Chowdhury
    AU  - Abu Salah Mohammamed Sirajum Munir
    AU  - Sohel Ahmed
    AU  - Mohammad Ashif Iqbal
    AU  - Mohammad Mushahidul Islam
    AU  - Md. Abdur Rahim
    Y1  - 2021/10/12
    PY  - 2021
    N1  - https://doi.org/10.11648/j.ajim.20210905.14
    DO  - 10.11648/j.ajim.20210905.14
    T2  - American Journal of Internal Medicine
    JF  - American Journal of Internal Medicine
    JO  - American Journal of Internal Medicine
    SP  - 236
    EP  - 243
    PB  - Science Publishing Group
    SN  - 2330-4324
    UR  - https://doi.org/10.11648/j.ajim.20210905.14
    AB  - Introduction: Inhaled corticosteroids effective medications for the treatment of asthma. Higher doses of inhaled fluticasone (1000 μgm / day) are commonly used in COPD. Such high doses have been associate with significant systemic effects such as pneumonia, glaucoma, cataracts, adrenal suppression and accelerated bone turnover. Aim of the study: The aim of the study was to evaluate the association between different doses of inhaled corticosteroids (Fluticasone Propionate µgm / day) and glycaemic status in Patients with Chronic Obstructive Pulmonary Disease. Material & Methods: This was a cross-sectional analytical study. This study was conducted at the department of Internal Medicine in Bangobandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, during May, 2016-April, 2017. The protocol of this study was approved by IRB and ethical committee. A total of 80 patients with COPD were included in this study, of them clinically diagnosed 40 consecutive COPD patients who were receiving both bronchodilator & inhaled corticosteroids were recruited as case group and clinically diagnosed 40 consecutive COPD patients receiving only bronchodilator without inhaled corticosteroid/systemic steroid were recruited as control, group. Spirometry was done for confirmation and staging of COPD according to GOLD at indoor and OPD patients of Department of Internal Medicine, BSMMU. Results: In case group, the inhaled corticosteroid dose (5000) was counted 02 (5%) and the mean of FPG value was 6.25±1.34, the inhaled corticosteroid dose (1000) was counted 27 (67.5%) and the mean of FPG value was 5.7±1.58, the inhaled corticosteroid dose (2000) was counted 11 (27.5%) and the mean of FPG value was 6.58±2.24. The total FPG mean of the doses was 5.97±1.78. Among case group according to inhaled corticosteroid dose in case group, the inhaled corticosteroid dose (500) was counted 02 (5%) and the mean of 2HABF value was 9.65±3.18, the inhaled corticosteroid dose (1000) was counted 27 (67.5%) and the mean of 2HABF value was 8.71±2.84, the inhaled corticosteroid dose (2000) was counted 11 (27.5%) and the mean of 2HABF value was 9.51±2.9. The total mean of 2HABF value of the doses was 8.98±2.82. In case group, the inhaled corticosteroid dose (500) was counted 02 (5%) and the mean of HbA1C value was 5.85±1.06, the inhaled corticosteroid dose (1000) was counted 27 (67.5%) and the mean of HbA1C value was 6.07±0.7, the inhaled corticosteroid dose (2000) was counted 11 (27.5%) and the mean of HbA1C value was 6.7±0.74. The total mean of HbA1C value of the doses was 6.23±0.77. Conclusion: We had found that 32% of cases and 7.5% of control group were diagnosed as diabetic when fasting plasma glucose taken into account, while in case of 2 hours after breakfast plasma sugar the number were 32.5% and 10% respectively and in case of HbA1c the number were 23.5% and 10% respectively.
    VL  - 9
    IS  - 5
    ER  - 

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Author Information
  • Department of Internal Medicine, National Institute of Cardiovascular Diseases (NICVD), Sher E, Banglanagar, Dhaka

  • Department of Medicine, Mugda Medical College Hospital, Mugda, Dhaka, Bangladesh

  • Department of Medicine, Chandpur Medical College, Chandpur, Bangladesh

  • Department of Medicine, Chottogram Medical College, Chottogram, Bangladesh

  • Department of Medicine, Mugda Medical College, Mugda, Dhaka, Bangladesh

  • Department of Medicine, 250 Bedded General Hospital, Chandpur, Bangladesh

  • Department of Respiratory Medicine, National Institute of Diseases of the Chest and Hospital, Mohakhali, Dhaka, Bangladesh

  • Department of Medicine, Sheikh Hasina Medical College, Jamalpur, Bangladesh

  • Department of Internal Medicine, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka, Bangladesh

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