The Association of COPD Exacerbations with New Onset Type 2 Diabetes among Medicare Patients
**Objective:** Chronic obstructive pulmonary disease (COPD) is highly prevalent in the elderly population and typically reduces overall quality of life. Exacerbations of COPD are commonly treated with corticosteroids, a class of drug known to cause insulin resistance. The objective of this study was...
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| Format: | Article |
| Language: | English |
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Columbia Data Analytics, LLC
2017-11-01
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| Series: | Journal of Health Economics and Outcomes Research |
| Online Access: | https://doi.org/10.36469/9810 |
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| author | Joseph S. Marino Cynthiya Ruban Christopher M. Blanchette |
| author_facet | Joseph S. Marino Cynthiya Ruban Christopher M. Blanchette |
| author_sort | Joseph S. Marino |
| collection | DOAJ |
| description | **Objective:** Chronic obstructive pulmonary disease (COPD) is highly prevalent in the elderly population and typically reduces overall quality of life. Exacerbations of COPD are commonly treated with corticosteroids, a class of drug known to cause insulin resistance. The objective of this study was to assess the rate of exacerbations requiring emergency room visits, hospitalizations or any medical encounter (a combination of emergency room and hospitalizations) between COPD patients who did and did not develop type 2 diabetes.
**Research Design and Methods:** A case-control study of COPD patients from the 2011-2012 Medicare 5% sample Limited Data Set (LDS) was conducted. Beneficiaries with at least 1 year of continuous enrollment and evidence of > 2 COPD-related claims (>1 primary diagnosis) were included in the study. Cases were defined as a beneficiary with a new claim for type 2 diabetes, whereas controls lacked evidence of type 2 diabetes (beneficiaries with evidence of non-incident type 2 diabetes were excluded).
**Results:** Of 27 456 COPD beneficiaries, 1274 developed incident type 2 diabetes (4.6%). After matching, 2536 beneficiaries were assigned as cases (n = 1268) and controls (n = 1268). Cases in the emergency room (1.97 claims per person) (p = <0.001) and hospitalizations (2.02 claims per person) (p = <0.001) had a higher rate of exacerbations.
**Conclusion:** Our findings suggest that patients that were hospitalized and visited the emergency room for COPD exacerbations had a greater likelihood of type 2 diabetes. Type 2 diabetes may be associated with exposure to corticosteroids as a result of the treatment for exacerbations. Future work should investigate the risk for type 2 diabetes in COPD patients treated with corticosteroids. |
| format | Article |
| id | doaj-art-0db86ea10c334c6ba2be3799ecb341ec |
| institution | Kabale University |
| issn | 2327-2236 |
| language | English |
| publishDate | 2017-11-01 |
| publisher | Columbia Data Analytics, LLC |
| record_format | Article |
| series | Journal of Health Economics and Outcomes Research |
| spelling | doaj-art-0db86ea10c334c6ba2be3799ecb341ec2025-02-10T16:12:30ZengColumbia Data Analytics, LLCJournal of Health Economics and Outcomes Research2327-22362017-11-0152The Association of COPD Exacerbations with New Onset Type 2 Diabetes among Medicare PatientsJoseph S. MarinoCynthiya RubanChristopher M. Blanchette**Objective:** Chronic obstructive pulmonary disease (COPD) is highly prevalent in the elderly population and typically reduces overall quality of life. Exacerbations of COPD are commonly treated with corticosteroids, a class of drug known to cause insulin resistance. The objective of this study was to assess the rate of exacerbations requiring emergency room visits, hospitalizations or any medical encounter (a combination of emergency room and hospitalizations) between COPD patients who did and did not develop type 2 diabetes. **Research Design and Methods:** A case-control study of COPD patients from the 2011-2012 Medicare 5% sample Limited Data Set (LDS) was conducted. Beneficiaries with at least 1 year of continuous enrollment and evidence of > 2 COPD-related claims (>1 primary diagnosis) were included in the study. Cases were defined as a beneficiary with a new claim for type 2 diabetes, whereas controls lacked evidence of type 2 diabetes (beneficiaries with evidence of non-incident type 2 diabetes were excluded). **Results:** Of 27 456 COPD beneficiaries, 1274 developed incident type 2 diabetes (4.6%). After matching, 2536 beneficiaries were assigned as cases (n = 1268) and controls (n = 1268). Cases in the emergency room (1.97 claims per person) (p = <0.001) and hospitalizations (2.02 claims per person) (p = <0.001) had a higher rate of exacerbations. **Conclusion:** Our findings suggest that patients that were hospitalized and visited the emergency room for COPD exacerbations had a greater likelihood of type 2 diabetes. Type 2 diabetes may be associated with exposure to corticosteroids as a result of the treatment for exacerbations. Future work should investigate the risk for type 2 diabetes in COPD patients treated with corticosteroids.https://doi.org/10.36469/9810 |
| spellingShingle | Joseph S. Marino Cynthiya Ruban Christopher M. Blanchette The Association of COPD Exacerbations with New Onset Type 2 Diabetes among Medicare Patients Journal of Health Economics and Outcomes Research |
| title | The Association of COPD Exacerbations with New Onset Type 2 Diabetes among Medicare Patients |
| title_full | The Association of COPD Exacerbations with New Onset Type 2 Diabetes among Medicare Patients |
| title_fullStr | The Association of COPD Exacerbations with New Onset Type 2 Diabetes among Medicare Patients |
| title_full_unstemmed | The Association of COPD Exacerbations with New Onset Type 2 Diabetes among Medicare Patients |
| title_short | The Association of COPD Exacerbations with New Onset Type 2 Diabetes among Medicare Patients |
| title_sort | association of copd exacerbations with new onset type 2 diabetes among medicare patients |
| url | https://doi.org/10.36469/9810 |
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