Respiratory Outcomes of Insulin Use in Patients with COPD: A Nationwide Population-Based Cohort Study
Acute exacerbations of chronic obstructive pulmonary disease (COPD) with severe hyperglycemia may require insulin to lower glucose levels in people with coexisting type 2 diabetes (T2D) and COPD. We conducted this study to examine the risk of hospitalization for COPD, pneumonia, ventilator use, lung...
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| Format: | Article |
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MDPI AG
2023-04-01
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| Series: | Pharmaceuticals |
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| Online Access: | https://www.mdpi.com/1424-8247/16/5/643 |
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| author | Fu-Shun Yen Shu-Hao Chang James Cheng-Chung Wei Ying-Hsiu Shih Chii-Min Hwu |
| author_facet | Fu-Shun Yen Shu-Hao Chang James Cheng-Chung Wei Ying-Hsiu Shih Chii-Min Hwu |
| author_sort | Fu-Shun Yen |
| collection | DOAJ |
| description | Acute exacerbations of chronic obstructive pulmonary disease (COPD) with severe hyperglycemia may require insulin to lower glucose levels in people with coexisting type 2 diabetes (T2D) and COPD. We conducted this study to examine the risk of hospitalization for COPD, pneumonia, ventilator use, lung cancer, hypoglycemia, and mortality with and without insulin use in people with T2D and COPD. We adopted propensity-score-matching to identify 2370 paired insulin users and non-users from Taiwan’s National Health Insurance Research Database between 1 January 2000 and 31 December 2018. Cox proportional hazards models and the Kaplan–Meier method were utilized to compare the risk of outcomes between study and control groups. The mean follow-up for insulin users and non-users was 6.65 and 6.37 years. Compared with no insulin use, insulin use was associated with a significantly increased risk of hospitalization for COPD (aHR 1.7), bacterial pneumonia (aHR 2.42), non-invasive positive pressure ventilation (aHR 5.05), invasive mechanical ventilation (aHR 2.72), and severe hypoglycemia (aHR 4.71), but with no significant difference in the risk of death. This nationwide cohort study showed that patients with T2D and COPD requiring insulin therapy may have an increased risk of acute COPD exacerbations, pneumonia, ventilator use, and severe hypoglycemia without a significant increase in the risk of death. |
| first_indexed | 2024-03-11T03:25:01Z |
| format | Article |
| id | doaj.art-0cd02700e1d44508997233bfff38195b |
| institution | Directory Open Access Journal |
| issn | 1424-8247 |
| language | English |
| last_indexed | 2024-03-11T03:25:01Z |
| publishDate | 2023-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Pharmaceuticals |
| spelling | doaj.art-0cd02700e1d44508997233bfff38195b2023-11-18T02:47:54ZengMDPI AGPharmaceuticals1424-82472023-04-0116564310.3390/ph16050643Respiratory Outcomes of Insulin Use in Patients with COPD: A Nationwide Population-Based Cohort StudyFu-Shun Yen0Shu-Hao Chang1James Cheng-Chung Wei2Ying-Hsiu Shih3Chii-Min Hwu4Dr. Yen’s Clinic, No. 15, Shanying Road, Gueishan District, Taoyuan 33354, TaiwanDivision of Pulmonary Medicine, Department of Internal Medicine, Cheng Ching Hospital, No. 139, Pingdeng Street, Central District, Taichung 40045, TaiwanDepartment of Allergy, Immunology & Rheumatology, Chung Shan Medical University Hospital, No. 110, Section 1, Jianguo N. Road, South District, Taichung 40201, TaiwanManagement Office for Health Data, China Medical University Hospital, Taichung 40201, TaiwanFaculty of Medicine, National Yang-Ming Chiao Tung University School of Medicine, No. 155, Section 2, Linong Street, Taipei 11221, TaiwanAcute exacerbations of chronic obstructive pulmonary disease (COPD) with severe hyperglycemia may require insulin to lower glucose levels in people with coexisting type 2 diabetes (T2D) and COPD. We conducted this study to examine the risk of hospitalization for COPD, pneumonia, ventilator use, lung cancer, hypoglycemia, and mortality with and without insulin use in people with T2D and COPD. We adopted propensity-score-matching to identify 2370 paired insulin users and non-users from Taiwan’s National Health Insurance Research Database between 1 January 2000 and 31 December 2018. Cox proportional hazards models and the Kaplan–Meier method were utilized to compare the risk of outcomes between study and control groups. The mean follow-up for insulin users and non-users was 6.65 and 6.37 years. Compared with no insulin use, insulin use was associated with a significantly increased risk of hospitalization for COPD (aHR 1.7), bacterial pneumonia (aHR 2.42), non-invasive positive pressure ventilation (aHR 5.05), invasive mechanical ventilation (aHR 2.72), and severe hypoglycemia (aHR 4.71), but with no significant difference in the risk of death. This nationwide cohort study showed that patients with T2D and COPD requiring insulin therapy may have an increased risk of acute COPD exacerbations, pneumonia, ventilator use, and severe hypoglycemia without a significant increase in the risk of death.https://www.mdpi.com/1424-8247/16/5/643mortalitybacterial pneumonianon-invasive positive pressure ventilationinvasive mechanical ventilationhypoglycemia |
| spellingShingle | Fu-Shun Yen Shu-Hao Chang James Cheng-Chung Wei Ying-Hsiu Shih Chii-Min Hwu Respiratory Outcomes of Insulin Use in Patients with COPD: A Nationwide Population-Based Cohort Study Pharmaceuticals mortality bacterial pneumonia non-invasive positive pressure ventilation invasive mechanical ventilation hypoglycemia |
| title | Respiratory Outcomes of Insulin Use in Patients with COPD: A Nationwide Population-Based Cohort Study |
| title_full | Respiratory Outcomes of Insulin Use in Patients with COPD: A Nationwide Population-Based Cohort Study |
| title_fullStr | Respiratory Outcomes of Insulin Use in Patients with COPD: A Nationwide Population-Based Cohort Study |
| title_full_unstemmed | Respiratory Outcomes of Insulin Use in Patients with COPD: A Nationwide Population-Based Cohort Study |
| title_short | Respiratory Outcomes of Insulin Use in Patients with COPD: A Nationwide Population-Based Cohort Study |
| title_sort | respiratory outcomes of insulin use in patients with copd a nationwide population based cohort study |
| topic | mortality bacterial pneumonia non-invasive positive pressure ventilation invasive mechanical ventilation hypoglycemia |
| url | https://www.mdpi.com/1424-8247/16/5/643 |
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