Impact of Diabetes on Chronic Obstructive Pulmonary Disease

Background We investigated the impact of diabetes on chronic obstructive pulmonary disease (COPD). Methods We retrospectively collected data from 323 patients admitted to the Department of Respiratory and Critical Care Medicine at Ningbo Ninth Hospital between August 1, 2021, and August 31, 2024. Seventy-two patients were diagnosed with comorbid COPD and diabetes (COPD with diabetes group), whereas 251 developed COPD without diabetes (COPD-only group). To minimize confounding factors, 110 of the 251 patients in the COPD-only group were selected through 1:2 propensity score matching, forming the propensity score-matched COPD-only group. The clinical characteristics, laboratory findings, pathogenic infections, and disease severity were compared between the COPD with diabetes group and the propensity score-matched COPD-only group via chi-square tests and nonparametric tests for continuous and categorical variables, respectively. Results Patients in the COPD with diabetes group were older (75.00 [68.00, 82.25] years) than those in the original COPD-only group were (71.00 [65.00, 78.00] years) (Z = -2.692, P = 0.007). Albumin levels were significantly lower in the COPD with diabetes group (36.65 [32.90, 39.65] g/L) than in the propensity score-matched COPD-only group (40.55 [36.52, 42.40] g/L) (Z = -4.423, P < 0.001). Conversely, hsCRP levels were markedly higher in the COPD with diabetes group (17.45 [8.30, 54.83] mg/L) than in the propensity score-matched COPD-only group (5.65 [0.50, 32.57] mg/L) (Z = -3.002, P = 0.03). The modified Medical Research Council score, which reflects disease severity, was also higher in the COPD with diabetes group (Z = -3.301, P < 0.001), as was the number of hospitalizations for acute exacerbations in the past year (Z = -3.780, P < 0.001). At the time of admission, random blood glucose and urine glucose levels correlated positively with mMRC scores, whereas albumin levels correlated negatively with forced expiratory volume according to one-second scores (all P < 0.05). Conclusion Patients with COPD and diabetes present a worse nutritional status, more severe symptoms, and an elevated risk of acute exacerbations, indicating a more severe overall disease condition. We need to pay more attention to this disease, actively control blood sugar and COPD, reduce the risk of aggravation, improve patients' quality of life, and reduce hospitalization frequency.