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Respiratory Outcomes of Insulin Use in Patients with COPD: A Nationwide Population-Based Cohort Study

Acute exacerbations of chronic obstructive pulmonary disease (COPD) with severe hyperglycemia may require insulin to lower glucose levels in people with coexisting type 2 diabetes (T2D) and COPD. We conducted this study to examine the risk of hospitalization for COPD, pneumonia, ventilator use, lung...

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Autores principales: Yen, Fu-Shun, Chang, Shu-Hao, Wei, James Cheng-Chung, Shih, Ying-Hsiu, Hwu, Chii-Min
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10222134/
https://www.ncbi.nlm.nih.gov/pubmed/37242426
http://dx.doi.org/10.3390/ph16050643
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author Yen, Fu-Shun
Chang, Shu-Hao
Wei, James Cheng-Chung
Shih, Ying-Hsiu
Hwu, Chii-Min
author_facet Yen, Fu-Shun
Chang, Shu-Hao
Wei, James Cheng-Chung
Shih, Ying-Hsiu
Hwu, Chii-Min
author_sort Yen, Fu-Shun
collection PubMed
description Acute exacerbations of chronic obstructive pulmonary disease (COPD) with severe hyperglycemia may require insulin to lower glucose levels in people with coexisting type 2 diabetes (T2D) and COPD. We conducted this study to examine the risk of hospitalization for COPD, pneumonia, ventilator use, lung cancer, hypoglycemia, and mortality with and without insulin use in people with T2D and COPD. We adopted propensity-score-matching to identify 2370 paired insulin users and non-users from Taiwan’s National Health Insurance Research Database between 1 January 2000 and 31 December 2018. Cox proportional hazards models and the Kaplan–Meier method were utilized to compare the risk of outcomes between study and control groups. The mean follow-up for insulin users and non-users was 6.65 and 6.37 years. Compared with no insulin use, insulin use was associated with a significantly increased risk of hospitalization for COPD (aHR 1.7), bacterial pneumonia (aHR 2.42), non-invasive positive pressure ventilation (aHR 5.05), invasive mechanical ventilation (aHR 2.72), and severe hypoglycemia (aHR 4.71), but with no significant difference in the risk of death. This nationwide cohort study showed that patients with T2D and COPD requiring insulin therapy may have an increased risk of acute COPD exacerbations, pneumonia, ventilator use, and severe hypoglycemia without a significant increase in the risk of death.
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spelling pubmed-102221342023-05-28 Respiratory Outcomes of Insulin Use in Patients with COPD: A Nationwide Population-Based Cohort Study Yen, Fu-Shun Chang, Shu-Hao Wei, James Cheng-Chung Shih, Ying-Hsiu Hwu, Chii-Min Pharmaceuticals (Basel) Article Acute exacerbations of chronic obstructive pulmonary disease (COPD) with severe hyperglycemia may require insulin to lower glucose levels in people with coexisting type 2 diabetes (T2D) and COPD. We conducted this study to examine the risk of hospitalization for COPD, pneumonia, ventilator use, lung cancer, hypoglycemia, and mortality with and without insulin use in people with T2D and COPD. We adopted propensity-score-matching to identify 2370 paired insulin users and non-users from Taiwan’s National Health Insurance Research Database between 1 January 2000 and 31 December 2018. Cox proportional hazards models and the Kaplan–Meier method were utilized to compare the risk of outcomes between study and control groups. The mean follow-up for insulin users and non-users was 6.65 and 6.37 years. Compared with no insulin use, insulin use was associated with a significantly increased risk of hospitalization for COPD (aHR 1.7), bacterial pneumonia (aHR 2.42), non-invasive positive pressure ventilation (aHR 5.05), invasive mechanical ventilation (aHR 2.72), and severe hypoglycemia (aHR 4.71), but with no significant difference in the risk of death. This nationwide cohort study showed that patients with T2D and COPD requiring insulin therapy may have an increased risk of acute COPD exacerbations, pneumonia, ventilator use, and severe hypoglycemia without a significant increase in the risk of death. MDPI 2023-04-24 /pmc/articles/PMC10222134/ /pubmed/37242426 http://dx.doi.org/10.3390/ph16050643 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Yen, Fu-Shun
Chang, Shu-Hao
Wei, James Cheng-Chung
Shih, Ying-Hsiu
Hwu, Chii-Min
Respiratory Outcomes of Insulin Use in Patients with COPD: A Nationwide Population-Based Cohort Study
title Respiratory Outcomes of Insulin Use in Patients with COPD: A Nationwide Population-Based Cohort Study
title_full Respiratory Outcomes of Insulin Use in Patients with COPD: A Nationwide Population-Based Cohort Study
title_fullStr Respiratory Outcomes of Insulin Use in Patients with COPD: A Nationwide Population-Based Cohort Study
title_full_unstemmed Respiratory Outcomes of Insulin Use in Patients with COPD: A Nationwide Population-Based Cohort Study
title_short Respiratory Outcomes of Insulin Use in Patients with COPD: A Nationwide Population-Based Cohort Study
title_sort respiratory outcomes of insulin use in patients with copd: a nationwide population-based cohort study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10222134/
https://www.ncbi.nlm.nih.gov/pubmed/37242426
http://dx.doi.org/10.3390/ph16050643
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