Use of inhaled corticosteroids and the risk of developing type 2 diabetes in patients with chronic obstructive pulmonary disease
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Use of inhaled corticosteroids and the risk of developing type 2 diabetes in patients with chronic obstructive pulmonary disease. / Saeed, Mohamad Isam; Eklof, Josefin; Achir, Imane; Sivapalan, Pradeesh; Meteran, Howraman; Lokke, Anders; Biering-Sørensen, Tor; Knop, Filip Krag; Jensen, Jens-Ulrik Stæhr.
In: Diabetes, Obesity and Metabolism, Vol. 22, No. 8, 2020, p. 1348-1356.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Use of inhaled corticosteroids and the risk of developing type 2 diabetes in patients with chronic obstructive pulmonary disease
AU - Saeed, Mohamad Isam
AU - Eklof, Josefin
AU - Achir, Imane
AU - Sivapalan, Pradeesh
AU - Meteran, Howraman
AU - Lokke, Anders
AU - Biering-Sørensen, Tor
AU - Knop, Filip Krag
AU - Jensen, Jens-Ulrik Stæhr
PY - 2020
Y1 - 2020
N2 - Aim To determine the risk of type 2 diabetes onset associated with accumulated inhaled corticosteroids (ICS) dose during the previous year in patients with chronic obstructive pulmonary disease (COPD).Materials and methods We conducted a nationwide observational cohort study based on data from patients with COPD between 1 January 2010 and 31 December 2017 extracted from Danish health databases. Patients were followed for 7 years, until death or a type 2 diabetes event. A propensity-matched Cox model and an adjusted Cox proportional hazards model (stratified on body mass index [BMI]) were used to estimate the hazard ratio (HR) for new-onset type 2 diabetes.Results A total of 50 148 patients with COPD were included, 3566 (7.1%) of whom had a type 2 diabetes event. During the previous year before study entry, 35 368 patients (70.5%) used ICS. The propensity-matched Cox model (N = 33 466) showed an increased risk of type 2 diabetes, which progressed with increasing accumulated ICS dose (low-ICS: HR 1.076, confidence interval [CI] 1.075-1.077, P <.0001; medium-ICS: HR 1.106, CI 1.105-1.108, P <.0001; high-ICS: HR 1.150, CI 1.148-1.151, P <.0001), compared with no ICS use. Results were confirmed in the adjusted Cox analysis on the entire study population, but only for patients with BMIConclusions In patients with COPD, ICS use was associated with a moderate dose-dependent increase in the occurrence of type 2 diabetes.
AB - Aim To determine the risk of type 2 diabetes onset associated with accumulated inhaled corticosteroids (ICS) dose during the previous year in patients with chronic obstructive pulmonary disease (COPD).Materials and methods We conducted a nationwide observational cohort study based on data from patients with COPD between 1 January 2010 and 31 December 2017 extracted from Danish health databases. Patients were followed for 7 years, until death or a type 2 diabetes event. A propensity-matched Cox model and an adjusted Cox proportional hazards model (stratified on body mass index [BMI]) were used to estimate the hazard ratio (HR) for new-onset type 2 diabetes.Results A total of 50 148 patients with COPD were included, 3566 (7.1%) of whom had a type 2 diabetes event. During the previous year before study entry, 35 368 patients (70.5%) used ICS. The propensity-matched Cox model (N = 33 466) showed an increased risk of type 2 diabetes, which progressed with increasing accumulated ICS dose (low-ICS: HR 1.076, confidence interval [CI] 1.075-1.077, P <.0001; medium-ICS: HR 1.106, CI 1.105-1.108, P <.0001; high-ICS: HR 1.150, CI 1.148-1.151, P <.0001), compared with no ICS use. Results were confirmed in the adjusted Cox analysis on the entire study population, but only for patients with BMIConclusions In patients with COPD, ICS use was associated with a moderate dose-dependent increase in the occurrence of type 2 diabetes.
KW - cohort study
KW - database research
KW - dose-response relationship
KW - observational study
KW - pharmaco-epidemiology
KW - type 2 diabetes
KW - SALMETEROL/FLUTICASONE PROPIONATE
KW - ONSET
KW - COPD
KW - EXACERBATIONS
KW - SALMETEROL
KW - SURVIVAL
U2 - 10.1111/dom.14040
DO - 10.1111/dom.14040
M3 - Journal article
C2 - 32239604
VL - 22
SP - 1348
EP - 1356
JO - Diabetes, Obesity and Metabolism
JF - Diabetes, Obesity and Metabolism
SN - 1462-8902
IS - 8
ER -
ID: 250073973