Higher HbA1c levels tied to acute exacerbations of COPD: CHEST

There are currently no proactive measures for decreasing acute exacerbations of chronic obstructive pulmonary disease (AECOPD) except for counseling on smoking cessation. Looking into a risk factor such as diabetes mellitus (DM) could be informative as a protective measure to help alleviate AECOPD admissions in several ways.

Therefore, Vijay Srinivasan and his colleagues conducted a retrospective cohort study in patients across fourteen HCA East Florida division. 1516 patients with COPD were identified and assessed. Patients were then classified into groups of incremental hbA1c levels starting from 5.1 – 6.0 to levels of 9.1 – 10. Rates of acute exacerbations of COPD for each individual hbA1c level was then analyzed. A chi-square model was used to identify the association and incidence of DM and its effects on the frequency of acute COPD exacerbation patients.

HbA1c concentrations were divided into cutoffs from 5.1-6.0, 6.1-7.0, 7.1-8.0, 8.1-9.0, and 9.1-10.0. These values were then examined in patients with the presence of COPD exacerbations that required hospitalization.

The following findings were noted by the authors-

a. 16.98% of patients with an HbA1c of 5.1-6.0 had COPD exacerbations.

b. There was a 1.98% rise to 18.87% of patients with a COPD exacerbation in patients with an HbA1c level from 6.1-7.0.

c. Furthermore, there was an increase of COPD exacerbations to 21.53% for hbA1c levels 7.1 – 8.0, representing a rise of 2.66%.

d. a 1.18% decline in the frequency of patients with COPD exacerbations from HbA1c levels 8.1-9.0 was observed.

e. a significant 5.31% surge in the frequency of COPD exacerbations in patients with levels of HbA1c of 9.1-10.0 was noted.

Hence, the authors concluded that "Our results strongly implicate uncontrolled blood sugars as an influencing factor in the frequency of AECOPD. By far, an overall increase in frequency from 18.87% for HbA1c levels of 6.1 - 7.0 to 25.66% AECOPD admissions for an HbA1c level of 9.1 - 10.0 highlights the correlation."

Looking into a risk factor such as diabetes mellitus (DM) could be informative as a protective measure to help alleviate AECOPD admissions in several ways. One can also explore why some AECOPD patients have better clinical outcomes, depending on diabetes mellitus as an influencing factor, they further added.

Therefore, the higher HbA1c levels are correlated with higher frequencies of admission for acute exacerbation of COPD.