Diabetes

Patients with COPD are at increased risk of developing type 2 diabetes.

Patients with both COPD and diabetes who are using a high-dose ICS to manage COPD are at increased risk of complications from diabetes. If an ICS is required in these patients, use the minimum effective dose and monitor blood glucose control closely.

Limit the use of oral corticosteroids in patients with COPD and diabetes. Consider the benefits of treatment and the potential short- and long-term adverse effects. Hypoglycaemic therapy may need to be escalated during oral corticosteroid courses, and subsequently de-escalated. For specific advice about corticosteroid use in patients with diabetes, see Glucocorticoid-induced hyperglycaemia.