Highlights
- •People with T2DM have a reduced risk of developing COPD compared with matched controls.
- •This may be related to positive life style changes, including smoking cessation, in those with T2DM.
- •Diabetes duration, diabetic complications and anti-diabetic medications did not alter COPD risk.
Abstract
Background
Chronic obstructive pulmonary disease (COPD) and type 2 diabetes (T2DM) are common
comorbidities. COPD is a known risk factor for incident T2DM, however few studies
have examined the relationship in reverse. The primary aim of this study was to compare
the incidence of COPD in people with and without T2DM.
Materials and methods
We conducted a retrospective case-control study using a long-established English general
practice network database (n = 894,646). We matched 29,217 cases of T2DM with controls, adjusting for age, gender,
smoking status, BMI and social deprivation, to achieve 1:1 propensity matching and
compared the rate of incident COPD over eight years of follow-up. We performed a secondary
analysis to investigate the effect of insulin, metformin and sulphonylureas on COPD
incidence.
Results
People with T2DM had a reduced risk of COPD compared to matched controls over the
follow-up period (HR 0.89, 95%CI 0.79–0.93). 48.5% of those with T2DM were ex-smokers
compared with 27.3% of those without T2DM. Active smoking rates were 20.4% and 23.7%
respectively. Insulin, metformin and sulphonylureas were not associated with incident
COPD.
Conclusions
People with T2DM are less likely to be diagnosed with COPD than matched controls.
This may be due to positive lifestyle changes, such as smoking cessation in those
with T2DM.
Keywords
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Article info
Publication history
Published online: May 26, 2018
Accepted:
May 2,
2018
Received in revised form:
April 30,
2018
Received:
March 1,
2018
Identification
Copyright
© 2018 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.
