- In patients with COPD, inhaled corticosteroid (ICS) treatment is associated with an increased risk of developing type 2 diabetes (T2D).
Why this matters
- Data on the association have conflicted.
- Real-world data suggest that ICS combined with long-acting beta-2 agonists is overused in patients with COPD.
- Electronic medical record data analyzed for 7078 patients with COPD age ≥40 years in 52 Swedish primary care centers, 2000-2014.
- High- and low-dose ICS defined as ≥640 and
- Funding: Uppsala University.
- T2D was reported in 5.9% (418) of patients.
- Compared with no ICS use and with adjustment for BMI, time since COPD, age, and sex, relative risks were (over the study period):
- Stable low-dose ICS: 1.32 (P=.0201).
- Stable high-dose ICS: 1.64 (P=.0088).
- For patients using high-dose ICS, T2D relative risks compared with no ICS were:
- Increased dosage: 2.00 (P=.0088).
- Mixed dosage: 1.96 (P=.0234).
- Adjustment for hypertension and/or heart failure did not significantly affect the results.
- Retrospective design introduces bias and confounding potential.
- Spirometry data not always available to verify COPD diagnosis or assess impact of disease severity.
- Single-country study.