Assessment of Glycemic Control in Veterans With Chronic Obstructive Pulmonary Disease and Type 2 Diabetes Mellitus on Inhaled Corticosteroid Therapy

Objective To determine if the use of inhaled corticosteroid (ICS) therapy affects glycemic control in patients with chronic obstructive pulmonary disease (COPD) and type 2 diabetes mellitus (T2DM). Background Studies have shown mixed evidence on the association between ICS use and worsening glycemic control in patients with preexisting diabetes. Methods Data were recorded from electronic medical records of veteran patients aged 18 to 80 with COPD and T2DM on at least 2 oral antiglycemic medications from January 1, 2000, to December 31, 2017, at the Veterans Affairs (VA) North Texas Health Care System (VANTHCS). The primary outcome was the rate of A1c progression >10% at 12 months and 5 years. Results This study included 127 (64 in the ICS group and 63 in the non-ICS group) patients; baseline characteristics between groups were similar with the exception of age and tobacco use. No statistically significant difference was found between groups with regard to the primary outcome. More patients in the non-ICS group had antiglycemic medications initiated at 12 months (P= .009) and 5 years (P= .003) compared to the ICS group. Conclusion Inhaled corticosteroids did not negatively impact glycemic control among veterans with comorbid COPD and T2DM.