ArticlePloS one
Metabolic Effects Associated with ICS in Patients with COPD and Comorbid Type 2 Diabetes: A Historical Matched Cohort Study.
Article in PloS one. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
31 citing papers in PubMed, 3 syntheses or guidelines pooled it, 78 citations in OpenAlex.
- Pooled it
- Systematic review on long-term adverse effects of inhaled corticosteroids in the treatment of COPD.European respiratory review : an official journal of the European Respiratory Society · 2021Pooled it
- Inhaled therapies for chronic obstructive pulmonary disease: a systematic review and meta-analysis.BMJ open · 2020Pooled it
- Efficacy of revefenacin, a long-acting muscarinic antagonist for nebulized therapy, in patients with markers of more severe COPD: a post hoc subgroup analysis.BMC pulmonary medicine · 2020Trial
- Relationship between metabolically unhealthy obesity and chronic obstructive pulmonary disease among U.S. adults: Evidence from NHANES 1999-2018.Clinics (Sao Paulo, Brazil) · 2026Article
- Leptin and Insulin in COPD: Unveiling the Metabolic-Inflammatory Axis-A Narrative Review.Journal of clinical medicine · 2025Review
- Extrapulmonary Comorbidities Associated with Chronic Obstructive Pulmonary Disease: A Review.International journal of chronic obstructive pulmonary disease · 2024Review
- Hyperglycaemia and Chronic Obstructive Pulmonary Disease.Diagnostics (Basel, Switzerland) · 2023Review
- Impact of inhaled and intranasal corticosteroids on glucose metabolism and diabetes mellitus: A mini review.World journal of diabetes · 2023Review
- The impact of metabolic overweight/obesity phenotypes on unplanned readmission risk in patients with COPD: a retrospective cohort study.Frontiers in physiology · 2023Article
- Mechanisms Linking COPD to Type 1 and 2 Diabetes Mellitus: Is There a Relationship between Diabetes and COPD?Medicina (Kaunas, Lithuania) · 2022Review
- Effects of inhaled corticosteroids (ICS) on lung microbiota and local immune response in long-term treatment of chronic obstructive pulmonary disease (COPD): utility of titration and therapeutic index.Naunyn-Schmiedeberg's archives of pharmacology · 2022Article
- Low-Value Inhaled Corticosteroids in Chronic Obstructive Pulmonary Disease and the Association with Healthcare Utilization and Costs.Annals of the American Thoracic Society · 2021Article
- GOLD 2021 Strategy Report: Implications for Asthma-COPD Overlap.International journal of chronic obstructive pulmonary disease · 2021Review
- Inhaled corticosteroids and the risk of type 2 diabetes among Swedish COPD patients.NPJ primary care respiratory medicine · 2020Observational
- Inhaled Corticosteroids in Chronic Obstructive Pulmonary Disease: Benefits and Risks.Clinics in chest medicine · 2020Review
- Observational
- Prevalence of Asthma Characteristics in COPD Patients in a Dutch Well-Established Asthma/COPD Service for Primary Care.International journal of chronic obstructive pulmonary disease · 2020Article
- Comparison of Characteristics Between ICS-Treated COPD Patients and ICS-Treated COPD Patients with Concomitant Asthma: A Study in Primary Care.International journal of chronic obstructive pulmonary disease · 2020Article
- Do Benefits Outweigh Risks for Corticosteroid Therapy in Acute Exacerbation of Chronic Obstructive Pulmonary Disease in People with Diabetes Mellitus?International journal of chronic obstructive pulmonary disease · 2020Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors at 7 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundManagement guidelines for chronic obstructive pulmonary disease (COPD) recommend that inhaled corticosteroids (ICS) are prescribed to patients with the most severe symptoms. However, these guidelines have not been widely implemented by physicians, leading to widespread use of ICS in patients with mild-to-moderate COPD. Of particular concern is the potential risk of worsening diabetic control associated with ICS use. Here we investigate whether ICS therapy in patients with COPD and comorbid type 2 diabetes mellitus (T2DM) has a negative impact on diabetic control, and whether these negative effects are dose-dependent. METHODS AND
findingsThis was a historical matched cohort study utilising primary care medical record data from two large UK databases. We selected patients aged ≥40 years with COPD and T2DM, prescribed ICS (n = 1360) or non-ICS therapy (n = 2642) between 2008 and 2012. The primary endpoint was change in HbA1c between the baseline and outcome periods. After 1:1 matching, each cohort consisted of 682 patients. Over the 12-18-month outcome period, patients prescribed ICS had significantly greater increases in HbA1c values compared with those prescribed non-ICS therapies; adjusted difference 0.16% (95% confidence interval [CI]: 0.05-0.27%) in all COPD patients, and 0.25% (95% CI: 0.10-0.40%) in mild-to-moderate COPD patients. Patients in the ICS cohort also had significantly more diabetes-related general practice visits per year and received more frequent glucose strip prescriptions, compared with those prescribed non-ICS therapies. Patients prescribed higher cumulative doses of ICS (>250 mg) had greater odds of increased HbA1c and/or receiving additional antidiabetic medication, and increased odds of being above the Quality and Outcomes Framework (QOF) target for HbA1c levels, compared with those prescribed lower cumulative doses (≤125 mg).
conclusionFor patients with COPD and comorbid T2DM, ICS therapy may have a negative impact on diabetes control. Patients prescribed higher cumulative doses of ICS may be at greater risk of diabetes progression.
trial registrationENCePP ENCEPP/SDPP/6804.
Identifiers
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.