EFFECT OF HYPERGLYCEMIA ON OUTCOME OF ACUTE EXACERBATION OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Introduction : The Global Initiative for Chronic Obstructive Lung Disease (GOLD) recently defined COPD as “Chronic Obstructive Pulmonary Disease (COPD) as a common, preventable and treatable disease that is characterized by persistent respiratory symptoms and airflow limitation that is due to airway and/or alveolar abnormalities usually caused by significant exposure to noxious particles or gases”. Hyperglycemia has been associated with increased morbidity, increased mortality, and longer lengths of stay, and more hospital costs in patients with both medical and surgical conditions. Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is associated with hyperglycemia due to the stress related hormonal response to acute illness and possibly some of the medications routinely used in the treatment of AECOPD. Aim: To study the effect of hyperglycemia on outcome of acute exacerbation of COPD and to compare the mean duration of hospital stay in acute exacerbation of COPD patients divided in to groups according to severity of hyperglycemia and HbA1C levels. Materials and Methods : This was a Prospective study done in KGMU, Lucknow. The study group comprised of COPD patients and admitted as acute exacerbation of COPD and severity was determined according to GOLD classification criteria, and their hospital stay was correlated with RBS and HbA1c. Results: A total of 107 patients of COPD were enrolled in the study of which 6 patients died. 101 patients underwent the follow up study. Duration of hospital stay among patients having RBS> 200 mg/dl was (9.63±2.04 days) and was found to be statistically significant to patients whose RBS was <200 mg/dl (6.89±2.08 days). Similar results were seen with pateints having HBA1c >6 and < 6. Conclusion: Strict control of blood sugar, in the pre hospitalization period as well as during hospital stay results in better outcomes and also shortened hospital stay; thus influencing both mortality and morbidity.