Fathur Nur Kholisa, Kevin Gracia Pratamab*, Jessica Novia Hadiyantoc
aDivison of Pulmonology, Department of Internal Medicine, Faculty of Medicine, Dr. Kariadi General Hospital, Diponegoro University, Semarang, Central Java, Indonesia, bFatima General Hospital, Ketapang Regency, West Kalimantan, Indonesia, cDepartment of Internal Medicine, Faculty of Medicine, Dr. Kariadi General Hospital, Diponegoro University, Semarang, Central Java, Indonesia
Open Access funded by Buddhist Compassion Relief Tzu Chi Foundation
Abstract
Objectives: Chronic obstructive pulmonary disease (COPD) patients have a higher risk of developing diabetes, and studies suggest that inhaled corticosteroids (ICSs) use may be associated with a higher risk of diabetes, particularly at higher doses. This study aims to investigate the effects of ICS use on the risk of diabetes and blood glucose levels in COPD patients. Materials and Methods: A systematic search was carried out on the PubMed, EBSCOhost, and ProQuest databases using the terms “Inhaled Corticosteroids,” “Diabetes,” and “Chronic Obstructive Pulmonary Disease” for the period between 2013 and 2023. The systematic review adhered to the PRISMA 2020 guideline. A meta‑analysis was conducted using a random‑effects model using the RevMan 5 software. Results: A total of 14 studies were included in the final analysis, with 10 randomized controlled trials (RCTs) and 4 observational studies. Two observational studies investigated the relationship between ICS dose and diabetes risk. A meta‑analysis of the RCTs studies showed a nonstatistically significant tendency toward increased blood glucose (odds ratio [OR] 1.07 and 95% confidence interval [CI] 0.88–1.30) after a 52‑week follow‑up. Whereas the observational studies showed a tendency toward an increased risk of diabetes (OR 1.40 and 95% CI 0.96–2.03). Furthermore, a subgroup meta‑analysis of high‑dose ICS (>900 µg/day) showed a significant increase in the risk of diabetes (OR 1.20 and 95% CI 1.09–1.32). Conclusion: Short‑term use of ICS does not have a significant effect on blood glucose. However, long‑term use, especially at higher doses, can increase the risk of developing diabetes.
Keywords: Chronic obstructive pulmonary disease, Diabetes, Inhaled corticosteroidscorticosteroids
