High Prevalence of Diabetes Mellitus in a Cohort of Patients with Chronic Obstructive Pulmonary Disease in Trinidad, West Indies

Özet

OBJECTIVES: Both chronic obstructive pulmonary disease (COPD) and diabetes mellitus (DM) are highly prevalent in Trinidad, WestIndies. Our objective was to evaluate the prevalence of DM in a cohort of Trinidadian patients with COPD and investigate the possibleimpact of diabetes on COPD using standard outcome measures, that is, lung function, exacerbations, quality of life and depressionquestionnaires, as well as mortality.MATERIALS AND METHODS: This was a cross-sectional follow-up study utilizing a cohort of 105 patients from chest clinics in the threemajor general hospitals in Trinidad.RESULTS: Diabetes was diagnosed based on a glycated hemoglobin (HbA1c) level of ≥6.5% (or a prior self-reported history), and forpre-diabetes, of 5.7%–6.4%. Of 105 patients, 40% fulfilled the criteria for diabetes and 40% for pre-diabetes. Of those diagnosed withdiabetes, 38% obtained this diagnosis de novo. A history of intravenous corticosteroid use was associated with higher HbA1c levels(p=0.043) upon diagnosis. The percentage of predicted forced vital capacity was negatively related to HbA1c (p=0.033), but those withdiabetes also had a greater body mass index (p=0.001). After a 1-year follow-up, mortality was significantly greater among patients withdiabetes (p=0.026). Patients with at least one exacerbation in the past year or poorer lung function parameters had worse quality of life(p≤0.040) and depression (p≤0.018) scores. Notably, 31.4% of the total cohort exhibited clinically significant depression scores.CONCLUSION: This study revealed that a high proportion of COPD patients in tertiary care had diabetes or pre-diabetes.