Clinical Characteristics Analysis Of Acute Exacerbation Period In Patients With Type 2 Diabetes Mellitus Combined With Chronic Obstructive Pulmonary Disease

Objective:Investigate the clinical features of patients with AECOPD and comorbid T2 DM and the impact of blood glucose control on them.Methods:This study retrospectively collected data from 300 AECOPD patients who were treated at Jiangxi Provincial People’s Hospital from January 2017 to October 2022.The patients were divided into three groups based on whether they had comorbid T2 DM and the level of glycated hemoglobin(HbA1c): the pure AECOPD group(Group A),the well-controlled blood glucose group(Group B),and the poorly controlled blood glucose group(Group C).The statistical analysis software SPSS27.0 was used to analyze and compare the hospitalization duration,BMI,pulmonary function,blood routine,blood biochemistry,inflammatory markers,and other variables among the groups.The study aimed to evaluate the impact of T2 DM and the level of blood glucose control on AECOPD patients.Results:1.No statistic differences were observed in gender,age,BMI,smoking history and hypertension history in Group A,B and C(gender: P=0.80,age: P=0.41,BMI:P=0.99,smoking history: P=0.84,hypertension history: P=0.84),whereas,statistic differences can be seen in hospitalization time amongst the 3 groups(P<0.01).2.There was no significant statistical difference observed among Groups A,B,and C in terms of FEV1/FVC%pred(P=0.97).However,statistically significant differences were found among the three groups in FVC%pred,FEV1%pred,MVV%pred,and DLCO%pred(FVC%pred: P < 0.01,FEV1%pred: P < 0.01,MVV%pred: P=0.01,DLCO%pred: P<0.01).3.No statistic differences were observed in PH,PO2 and PCO2 in Group A,B and C(PH: P=0.12,PO2: P=0.59,PCO2: P=0.99).4.No statistic differences were observed in WBC,RBC,Hb and FENO in Group A,B and C(WBC: P=0.39,RBC: P=0.80,Hb: P=0.18,FENO: P=0.22),whereas,statistic differences can be seen in NEU%,LMY%、NLR,CRP and LDH amongst the 3 groups(NEU%: P=0.02,LMY%: P=0.01,NLR: P=0.01,CRP: P=0.02,LDH:P<0.01).5.No statistic differences were observed in the rate of obesity or overweight,hyperuricemia,and dyslipidemia in Group A,B and C(obesity or overweight: P=0.13,hyperuricemia: P=0.70,dyslipidemia: P=0.84),whereas,statistic differences can be seen in the rate of anemia amongst the 3 groups(P=0.01).6.In AECOPD patients with T2 DM,HbA1 c was linearly positively correlated with hospitalization time,r = 0.39(P<0.01).7.In AECOPD patients with T2 DM,HbA1 c was linearly negatively correlated with FEV1%pred(r=-0.27,P < 0.01),DLco%pred(r=-0.29,P < 0.01),and MVV%pred(r=-0.28,P<0.01).8.BMI was linearly positively correlated with FEV1%pred(r=0.30,P < 0.01)and DLco%pred(r=0.31,P<0.01)in AECOPD patients.Conclusion:1.The hospitalization duration is significantly prolonged and the pulmonary function impairment is significantly aggravated in AECOPD patients with concomitant T2 DM compared to those with AECOPD alone.Furthermore,the hospitalization duration and the degree of pulmonary function impairment are positively correlated with HbA1 c levels.2.Poor blood sugar control significantly increases the overall inflammation levels and the risk of anemia in patients with AECOPD.3.BMI is positively correlated with lung ventilation and diffusion function in AECOPD patients,suggesting that higher BMI levels may serve as protective factors for the prognosis of AECOPD patients.