title: The impact of corticosteroid treatment on hemoglobin A1C levels among patients with type-2 diabetes with chronic obstructive pulmonary disease exacerbation.
abstract: BACKGROUND
  Corticosteroid-induced hyperglycemia is a known adverse effect. There are no studies on the impact of corticosteroid treatment on hemoglobin A1c (HbA1c) levels in type-2 diabetes patients with chronic obstructive pulmonary disease (COPD) exacerbation.
  
  
  METHODS
  HbA1c levels were evaluated in type-2 diabetes patients with COPD exacerbation on admission to the hospital (group-1) and 3-months later. Demographic, clinical, laboratory variables and total steroid dose were documented. Age- and sex-matched group of type-2 diabetes patients with COPD who were admitted for other reasons (group-2), were asked to participate as a control group. Mann-Whitney and Chi square/Fischer's exact tests were used to compare between the parameters of the two groups. Wilcoxon's signed rank test was used to compare between HbA1c levels at baseline and 3 months later. Multi-variate linear regression analysis was used to find predictors for a change in HbA1c levels in group-1 patients.
  
  
  RESULTS
  23 and 21 patients in groups 1 and 2 respectively, completed the study. There were 39 male (∼89%) patients. Mean age of the patients was 66.2 ± 8.2 years. In both groups, anti-diabetic management was augmented. There was no significant change in the HbA1c levels in group-1 (p = 0.416), however there was a significant decrease in HbA1c levels in group-2 (p = 0.032). Total dose of steroids was a predictor for an increase in HbA1c levels in group-1 patients (p = 0.026).
  
  
  CONCLUSIONS
  Type-2 diabetes patients who were treated with steroids for COPD exacerbation had no significant change in HbA1c levels. Total dose of steroids was a predictor for an increase in HbA1c levels.
authors.affiliation: Department of Medicine, Carmel Medical Center, Haifa, Israel; Rheumatology Clinic, Nazareth Hospital, Nazareth, Israel. Electronic address: gshabib@gmail.com.
authors.forename: George
authors.initials: G
authors.lastname: Habib
authors.affiliation: Department of Medicine, Nazareth Hospital, Nazareth, Israel.
authors.forename: Yusri
authors.initials: Y
authors.lastname: Dar-Esaif
authors.affiliation: Pulmonary Unit, Nazareth Hospital, Nazareth, Israel.
authors.forename: Hashim
authors.initials: H
authors.lastname: Bishara
authors.affiliation: Department of Radiology, Nazareth Hospital, Nazareth, Israel.
authors.forename: Suheil
authors.initials: S
authors.lastname: Artul
authors.affiliation: Department of Neurology, Carmel Medical Center, Haifa, Israel.
authors.forename: Samih
authors.initials: S
authors.lastname: Badarny
authors.affiliation: Department of Medicine, Carmel Medical Center, Haifa, Israel.
authors.forename: Mark
authors.initials: M
authors.lastname: Chernin
authors.affiliation: Central Lab, Nazareth Hospital, Nazareth, Israel.
authors.forename: Adel
authors.initials: A
authors.lastname: Jabbour
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000378:metabolism; D016022:Case-Control Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications; D005260:Female; D005938:Glucocorticoids / Q000494:pharmacology* / Q000627:therapeutic use; D006442:Glycated Hemoglobin / Q000187:drug effects* / Q000378:metabolism; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000188:drug therapy*
chemical_list: D001786:Blood Glucose; D005938:Glucocorticoids; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human
keywords: Chronic obstructive pulmonary disease exacerbation; Corticosteroids; Diabetes; Hemoglobin A1c