Analysis of factors of poor outcome in patients with COPD and type 2 diabetes mellitus: results of a 10-year follow-up


DOI: https://dx.doi.org/10.18565/therapy.2021.8.38-45

Ignatova I.V., Blinova E.V., Antonov V.N.

South Ural State Medical University of the Ministry of Healthcare of Russia, Chelyabinsk
Abstract. The problem of the comorbidity of chronic obstructive pulmonary disease (COPD) and type 2 diabetes mellitus (DM) is relevant and till nowadays insufficiently studied.
The aim of the study is to establish the leading factors of unfavorable outcome in patients with a combination of COPD and type 2 diabetes according to the results of a 10-year supervision.
Material and methods. The study included 167 patients, divided into two observation groups: the first (n=83) consisted of patients with an isolated COPD clinical course, the second (n=84) – of patients with a combination of COPD and type 2 DM.
Results. During long-term observation it was found, that the leading cause of death in both observed groups of patients was community-acquired pneumonia, but the number of deaths among comorbid patients was 2.5 times higher than in the isolated course of COPD. In both groups, died patients had significantly higher rates of smoking intensity and BMI comparatively to patients who continued to be observed. The clinical course of COPD in the group of comorbid patients is characterized by more pronounced shortness of breath; this was confirmed by significant bronchial obstruction, frequent (≥2 per year) and long-term COPD exacerbations, repeated hospitalizations (including admission to the ICU) comparatively with the isolated course of COPD, which, in turn, is associated with a risk of poor outcome. Among died patients, both with an isolated course of COPD and with its combination with diabetes, there was fixed a high frequency of inhaled GCS use (81 and 90,6%, respectively), while in the groups that continued to be observed, double bronchodilation therapy was mainly used.
Conclusion. According to the results of 10-year supervision, it was found that the combined course of COPD and type 2 diabetes increases the risk of an unfavorable outcome. The main causes of death in these patients in the study were community-acquired pneumonia and cardiovascular diseases. The risk factors for death are high smoking index and BMI, frequent exacerbations of COPD and hospitalizations during the year, as well as excessive use of inhaled GCS.
Keywords: clinical manifestations, chronic obstructive pulmonary disease, diabetes mellitus, risk factors, prognosis
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About the Autors

Galina L. Ignatova, MD, professor, head of the Department of therapy, Institute of extended professional education, South Ural State Medical University of the Ministry of Healthcare of Russia. Address: 454021, Chelyabinsk, 81 Ostrovskogo Str. E-mail: iglign@mail.ru. ORCID: 0000-0002-0877-6554
Elena V. Blinova, PhD, associate professor of the Department of therapy, Institute of extended professional education, South Ural State Medical University of the Ministry of Healthcare of Russia. Address: 454021, Chelyabinsk, 81 Ostrovskogo Str. E-mail: blinel@mail.ru. ORCID: 0000-0003-2507-5941
Vladimir N. Antonov, MD, professor of the Department of therapy, Institute of extended professional education, South Ural State Medical University of the Ministry of Healthcare of Russia. Address: 454021, Chelyabinsk, 81 Ostrovskogo Str. E-mail: ant-vn@yandex.ru. ORCID: 0000-0002-3531-3491


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