COPD patients with comorbid diabetes should not receive high-dose corticosteroids whenever possible to avoid an associated increased risk of diabetes-related hospitalizations, according to research in the current issue of Diabetes Care. Physicians should closely monitor blood glucose and review inhaled corticosteroid therapy efficacy within 4-8 weeks, regardless of dosage, the authors believe.

For the study, investigators performed a competing risk analysis for 1077 patients aged a median of 80 years with comorbid COPD and diabetes, finding that those took high-dose corticosteroids had a 94% greater risk for hospitalization for diabetes complications during their first year of antidiabetic treatment, regardless of administration route.

Noting that older patients and those with comorbidities are often excluded from clinical trials, the authors said their findings “provide an insight into potential safety concerns of corticosteroid use in a real-world setting for the treatment of COPD in patients with comorbid diabetes, where both oral and systemic corticosteroids are used.”