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The Capital Region of Denmark - a part of Copenhagen University Hospital
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Use of inhaled corticosteroids and the risk of developing type 2 diabetes in patients with chronic obstructive pulmonary disease

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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 BMI <30 kg/m 2. Conclusions: In patients with COPD, ICS use was associated with a moderate dose-dependent increase in the occurrence of type 2 diabetes.

Original languageEnglish
JournalDiabetes, Obesity and Metabolism
Volume22
Issue number8
Pages (from-to)1348-1356
Number of pages9
ISSN1462-8902
DOIs
Publication statusPublished - 1 Aug 2020

Bibliographical note

© 2020 John Wiley & Sons Ltd.

    Research areas

  • cohort study, database research, dose-response relationship, observational study, pharmaco-epidemiology, type 2 diabetes

ID: 59633913