Risk Assessment of Diabetes Mellitus in Chronic Obstructive Pulmonary Disease (COPD) Patients Visiting Tertiary Care Hospitals in Peshawar, Pakistan

. Romasa; Shumaila Ihtisham; . Hafsa

doi:10.54112/bcsrj.v7i3.2001

Authors

. Romasa Department of Chemistry, Islamia College University, Peshawar, Pakistan
Shumaila Ihtisham Department of Statistics, Islamia College University, Peshawar, Pakistan
. Hafsa Department of Chemistry, Islamia College University, Peshawar, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v7i3.2001

Keywords:

COPD, Diabetes mellitus, HbA1c, GOLD stage, Comorbidity

Abstract

Chronic Obstructive Pulmonary Disease (COPD) is a major cause of morbidity and mortality worldwide and is frequently associated with systemic comorbidities, particularly Type 2 Diabetes Mellitus (T2DM). The coexistence of COPD and diabetes may worsen clinical outcomes, yet limited data exist regarding this association in Peshawar, Pakistan. Objective: To assess the prevalence and risk of diabetes mellitus among COPD patients attending tertiary care hospitals in Peshawar. Methods: A hospital-based study was conducted among 100 confirmed COPD patients at Hayatabad Medical Complex, Khyber Teaching Hospital, and Lady Reading Hospital from September to December 2023. Demographic and clinical data were collected using a structured questionnaire. COPD severity was evaluated using spirometry and GOLD classification. Glycemic status was assessed using HbA1c and random blood glucose levels. Data were analyzed using SPSS version 25, and associations were tested using the chi-square test with p < 0.05 considered significant. Results: Among the participants, 64% were male, and most were aged 60–69 years. Severe disease (GOLD stage D) was observed in 76% of patients. HbA1c results showed that 33% of patients had diabetes and 14% were pre-diabetic. Significant associations were observed between BMI and diabetes status (p = 0.026) and between GOLD stage and diabetes status (p = 0.001). COPD awareness among patients was very limited. Conclusion: Diabetes and pre-diabetes are common among COPD patients in Peshawar, particularly in advanced disease stages, highlighting the need for routine metabolic screening and integrated disease management.

Downloads

Download data is not yet available.

2

References

1. Ullah R, Ahmad S, Bahadur S, Shireen F. Frequency of atrial fibrillation in patients presenting with decompensated heart failure. Cureus. 2021. DOI: https://doi.org/10.7759/cureus.20594

2. Haider I, Badshah A, Rahman S, Ullah M, Fayyaz M, Mohammad W. Risk factors for hypertension in patients with stroke presenting to a tertiary care hospital. J Gandhara Med Dent Sci. 2023;10(4):17-20. DOI: https://doi.org/10.37762/jgmds.10-4.469

3. Chaisuksant S, Suwannatat P, Sawanyawisuth K. Prevalence and risk factors of depression in patients with chronic obstructive airway disease: a tertiary care hospital outpatient setting. Multidiscip Respir Med. 2024;19. DOI: https://doi.org/10.5826/mrm.2024.951

4. Fayyaz S, Butt M, Khan S, Ali A, Abbas H. Family history of diabetes: an important risk factor for developing PCOS. Pak J Med Health Sci. 2022;16(4):1204-1206. DOI: https://doi.org/10.53350/pjmhs221641204

5. Badshah S, Bilal M, Masood A, Khan Y. Frequency of newly diagnosed diabetes in hemorrhagic stroke patients presenting to a tertiary care hospital in Peshawar. Pak J Public Health. 2022;12(2):64-67. DOI: https://doi.org/10.32413/pjph.v12i2.986

6. Al-Ani N, Alobaidy M. The prevalence of diabetes mellitus type 2 in severe and very severe chronic obstructive pulmonary disease patients. Iraqi J Med Sci. 2022;20(2):269-277. DOI: https://doi.org/10.22578/IJMS.20.2.15

7. Liao L, Chen K, Cheng H, Hsu H. Factors influencing diabetes awareness in older people with chronic obstructive pulmonary disease comorbid with type 2 diabetes mellitus. J Nurs Res. 2024;32(2):e323. DOI: https://doi.org/10.1097/jnr.0000000000000602

8. Sridhara V, Acharya V. Comorbidities of chronic obstructive pulmonary disease and their effect on hospitalization of patients in a tertiary care hospital. J Community Hosp Intern Med Perspect. 2021;11(1):120-123. DOI: https://doi.org/10.1080/20009666.2020.1843823

9. Liang Z, Yang M, Xu C, Zeng R, Dong L. Effects and safety of metformin in patients with concurrent diabetes mellitus and chronic obstructive pulmonary disease: a systematic review and meta-analysis. Endocr Connect. 2022;11(9). DOI: https://doi.org/10.1530/EC-22-0289

10. Karim H, Afridi S, Maqsood S, Khan F, Mushtaq A, Rehman S, et al. COPD (chronic obstructive pulmonary disease): its comorbidity and other respiratory problems in selected tertiary care hospitals of Peshawar, KP. Northwest J Med Sci. 2023;2(1). DOI: https://doi.org/10.69723/njms.02.01.0303

11. Kumar A, Gupta S, Chaudhri S, Verma S, Kumar A, Sinha S, et al. A study to investigate the prevalence of metabolic syndrome in chronic obstructive pulmonary disease patients from North India. Int J Res Med Sci. 2019;8(1):337. DOI: https://doi.org/10.18203/2320-6012.ijrms20195933

12. Su J, Li M, Wan X, Yu H, Wan Y, Hang D, et al. Associations of diabetes, prediabetes and diabetes duration with the risk of chronic obstructive pulmonary disease: a prospective UK Biobank study. Diabetes Obes Metab. 2023;25(9):2575-2585. DOI: https://doi.org/10.1111/dom.15142

13. Gupta S, Singh A, Meena A, Bajpai A. A study to investigate the prevalence of metabolic and metabolic-like syndrome in stable COPD patients. Glob J Res Anal. 2020:1-3. DOI: https://doi.org/10.36106/gjra/5700201

14. Santos N, Miravitlles M, Camelier A, Almeida V, Maciel R, Camelier F. Prevalence and impact of comorbidities in individuals with chronic obstructive pulmonary disease: a systematic review. Tuberc Respir Dis. 2022;85(3):205-220. DOI: https://doi.org/10.4046/trd.2021.0179

15. Bera M, Gupta A, Ahmed R, Baidya A, Guha M. Prevalence and severity of chronic obstructive pulmonary disease in people with type 2 diabetes: a cross-sectional study. Clin Diabetol. 2023;12(5):308-314. DOI: https://doi.org/10.5603/cd.95828

16. Tønnesen P, Marott J, Nordestgaard B, Bojesen S, Lange P. Secular trends in smoking in relation to prevalent and incident smoking-related disease: a prospective population-based study. Tob Induc Dis. 2019;17. DOI: https://doi.org/10.18332/tid/112459

17. Gonçálves J, Pérez J, Cabrera-López C, Wangüemert-Pérez A, García-Talavera I, Ramallo-Fariña Y, et al. Characteristics of patients referred to Canary Island pneumology outpatient services for chronic obstructive pulmonary disease: the EPOCan study. BMC Res Notes. 2022;15(1). DOI: https://doi.org/10.1186/s13104-022-05930-7

18. Covanțev S, Corlateanu O, Volkov S, Uzdenov R, Botnaru V, Corlăteanu A. COPD and diabetes mellitus: down the rabbit hole. Curr Respir Med Rev. 2022;18(2):95-103. DOI: https://doi.org/10.2174/1573398X18666220411123508

19. Gonçálves J, Bello M, Golpe R, Jerez J, García-Talavera I. Impact of diabetes mellitus on the risk of severe exacerbation in patients with chronic obstructive pulmonary disease. Clin Respir J. 2020;14(12):1208-1211. DOI: https://doi.org/10.1111/crj.13255

20. Pangaribuan M, Yunus F, Damayanti T, Rochsismandoko R. The prevalence of diabetes mellitus in chronic obstructive pulmonary disease patients. J Respirol Indones. 2020;40(1):48-57. DOI: https://doi.org/10.36497/jri.v40i1.97

21. Ghafil N, Dananah F, Hassan E, Alkaabi Y. Comorbidities in patients with chronic obstructive pulmonary disease: a comprehensive study. J Med Life. 2023;16(7):1013-1016. DOI: https://doi.org/10.25122/jml-2022-0057

22. Dewi A, Yunus F, Walenna N. Association of chronic obstructive pulmonary disease exacerbation with type-2 diabetes mellitus comorbidity: possible role of IL-8. Int J Res Rev. 2024;11(10):441-444. DOI: https://doi.org/10.52403/ijrr.20241039

23. Cave A, Pham A, Lindeman C, Soós B, Williamson T, Drummond N. Chronic obstructive pulmonary disease as a risk factor in primary care: a Canadian retrospective cohort study. NPJ Prim Care Respir Med. 2021;31(1). DOI: https://doi.org/10.1038/s41533-021-00249-5

24. Gunasekaran K, Murthi S, Elango K, Rahi M, Thilagar B, Ramalingam S, et al. The impact of diabetes mellitus in patients with chronic obstructive pulmonary disease hospitalization. J Clin Med. 2021;10(2):235. DOI: https://doi.org/10.3390/jcm10020235