Abstract
Aims
To investigate whether type 2 diabetes mellitus (T2DM) increases the risk of developing
chronic obstructive pulmonary disease (COPD).
Methods
This population-based cohort study used Taiwan’s National Health insurance claim data
to investigate the association of T2DM with the risk of COPD. A total of 716,623 pairs
of people (patients with T2DM and their age-, sex-, and calendar year-matched controls)
were identified in 2002–2003 and were followed until the occurrence of newly-diagnosed
COPD or the end of 2011. Cox proportional hazard models were used to relate COPD incidence
to T2DM.
Results
People with T2DM experienced a higher incidence rate of COPD than controls (159.6
vs 122.7 per 104 person-years). After controlling for confounders, T2DM significantly increased the
hazard of COPD (hazard ratio [HR] = 1.15, 95% confidence interval = 1.14–1.16). Stratified
analysis indicated that the association between T2DM and COPD was slightly greater
in women than in men (HR, 1.15 vs. 1.11) and in people aged <65 years than in people
aged ≥65 years (HR, 1.17 vs. 1.05 in men; 1.16 vs. 1.13 in women).
Conclusions
Our findings demonstrated a modest association of T2DM with the risk of developing
COPD, possibly shedding light into the adverse effects of hyperglycemia on pulmonary
function.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Diabetes Research and Clinical PracticeAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- IDF Diabetes Atlas estimates of 2014 global health expenditures on diabetes.Diabetes Res Clin Pract. 2016; 117: 48-54
- Prevalence and outcomes of diabetes, hypertension and cardiovascular disease in COPD.Eur Respir J. 2008; 32: 962-969
- Projections of global mortality and burden of disease from 2002 to 2030.PLoS Med. 2006; 3: e442
- Beyond comorbidity counts: how do comorbidity type and severity influence diabetes patients’ treatment priorities and self-management?.J Gen Intern Med. 2007; 22: 1635-1640
- Comorbidity in the elderly with diabetes: identification of areas of potential treatment conflicts.Diabetes Res Clin Pract. 2010; 87: 385-393
- The prevalence of metabolic syndrome in chronic obstructive pulmonary disease: a systematic review.COPD. 2016; 13: 399-406
- Comorbidity between chronic obstructive pulmonary disease and type 2 diabetes: a nation-wide cohort twin study.Respir Med. 2015; 109: 1026-1030
- Metabolic and inflammatory profile in obese patients with chronic obstructive pulmonary disease.Chron Respir Dis. 2008; 5: 35-41
- Metabolic syndrome as a factor affecting systemic inflammation in patients with chronic obstructive pulmonary disease.Adv Exp Med Biol. 2017;
- Chronic obstructive pulmonary disease: a risk factor for type 2 diabetes: a nationwide population-based study.Eur J Clin Invest. 2013; 43: 1113-1119
- Risk of new onset diabetes mellitus in patients with asthma or COPD taking inhaled corticosteroids.Respir Med. 2012; 106: 1487-1493
- Lung dysfunction in diabetes.Diabetes Care. 2003; 26: 1915-1918
- Type II diabetes mellitus is associated with decreased measures of lung function in a clinical setting.Respir Med. 2011; 105: 1095-1098
- Chronic obstructive pulmonary disease and glucose metabolism: a bitter sweet symphony.Cardiovasc Diabetol. 2012; 11: 132
- Glucose homeostasis across human airway epithelial cell monolayers: role of diffusion, transport and metabolism.Pflugers Arch. 2009; 457: 1061-1070
- Blood glucose: of emerging importance in COPD exacerbations.Thorax. 2009; 64: 830-832
- Crosssectional and prospective study of lung function in adults with type 2 diabetes: the Atherosclerosis Risk in Communities (ARIC) study.Diabetes Care. 2008; 31: 741-746
- COPDGene Investigators. Pulmonary function reduction in diabetes with and without chronic obstructive pulmonary disease.Diabetes Care. 2014; 37: 389-395
- Mortality in a large population-based cohort of patients with drug treated diabetes mellitus.Am J Public Health. 1998; 88: 765-770
- Patients diagnosed with diabetes are at increased risk for asthma, chronic obstructive pulmonary disease, pulmonary fibrosis, and pneumonia but not lung cancer.Diabetes Care. 2010 Jan; 33: 55-60
National Health Insurance Administration (2005) Statistics and Surveys. Available from http://www.nhi.gov.tw/English/webdata/webdata.aspx?menu=11&menu_id=296&webdata_id=1942&WD_ID=296. Accessed February 9, 2017.
- Age and sex may significantly interact with diabetes on the risks of lower extremity amputation and peripheral revascularization procedures: evidence from a cohort of a half million diabetic patients.Diabetes Care. 2006; 29: 2409-2414
- Risk of malignant neoplasms of liver and biliary tract in diabetic patients with different age and sex stratifications.Hepatology. 2010; 52: 155-163
- Incorporating development stratification of Taiwan townships into sampling design of large scale health interview survey.J Health Manag. 2006; 4: 1-22
- Accessibility assessment of the health care improvement program in rural Taiwan.J Rural Health. 2005; 21: 372-377
- Pulmonary function in diabetes: a meta analysis.Chest. 2010; 138: 393-406
- Inadequate glucose control in type 2 diabetes is associated with impaired lung function and systemic inflammation: a cross-sectional study.BMC Pulm Med. 2010; 10: 38
Aparna: Pulmonary function tests in type 2 diabetics and non-diabetic people – a comparative study. J Clin Diagn Res. 2013; 7: 1606–1608.
- Extreme values of hemoglobin a1c are associated with increased risks of chronic obstructive pulmonary disease in patients with type 2 diabetes: a competing risk analysis in national cohort of Taiwan diabetes study.Medicine. 2015; 94: e367
- Visit-to-visit glycemic variability is a strong predictor of chronic obstructive pulmonary disease in patients with type 2 diabetes mellitus: competing risk analysis using a national cohort from the Taiwan diabetes study.PLoS ONE. 2017; 12: e0177184
- Attenuated superoxide dismutase induction in retinal cells in response to intermittent high versus continuous high glucose.Am J Biochem Biotechol. 2007; 3: 16-23
- Constant and intermittent high glucose enhances endothelial cell apoptosis through mitochondrial superoxide overproduction.Diabetes Metab Res Rev. 2006; 22: 198-220
- Comorbidities and risk of mortality in patients with chronic obstructive pulmonary disease.Am J Respir Crit Care Med. 2012; 186: 155-161
- NIDDM, impaired glucose tolerance, and pulmonary function in older adults: the Rancho Bernardo Study.Diabetes Care. 1996; 19: 1441-1444
- Risk factors for early death in non-insulin dependent diabetes and men with known glucose tolerance status.BMJ. 1993; 307: 295-299
- Does Improving exercise capacity and daily activity represent the holistic perspective of a new COPD approach?.COPD. 2015; 12: 575-581
- Socioeconomic inequality in clusters of health-related behaviours in Europe: latent class analysis of a cross-sectional European survey.BMC Public Health. 2017; 17: 497
- The costs of smoking and secondhand smoke exposure in Taiwan: a prevalence-based annual cost approach.BMJ Open. 2014; 4: e005199
Article info
Publication history
Published online: February 03, 2018
Accepted:
January 30,
2018
Received in revised form:
January 5,
2018
Received:
October 18,
2017
Identification
Copyright
© 2018 Elsevier B.V. All rights reserved.
