EDITORIALS
Blood glucose: of emerging importance in COPD exacerbations
1 St George’s, University of London, London, UK
2 Imperial College, Chelsea and Westminster Hospital, London, UK
Correspondence to:
Correspondence to Dr Emma Baker, Centre for Clinical Pharmacology, Division of Basic Medical Sciences, St George’s, University of London, Cranmer Terrace, London SW17 0RE, UK; ebaker@sgul.ac.uk
| The first 150 words of the full text of this article appear below. |
Elevated blood glucose is a well recognised and common pathophysiological response to acute illness. The underlying mechanisms include acute increases in hepatic glucose production and peripheral insulin resistance, driven by increases in glucocorticoids, catecholamines and proinflammatory cytokines.1 Acute hyperglycaemia can occur in any acutely unwell patient, irrespective of baseline glucose tolerance, if the illness is sufficiently severe. Acute hyperglycaemia is associated with poor outcomes from a wide range of acute illnesses including myocardial infarction,2 stroke,3 trauma4 and pneumonia.5
The data in relation to hyperglycaemia and acute exacerbations of chronic obstructive pulmonary disease (COPD) are now beginning to emerge. In a previous study, more than 50% patients with acute exacerbations of COPD had random blood glucose 
7 mM during their hospital stay.6 This retrospective study could not fully elucidate the relative contributions of acute illness, steroid therapy and underlying diabetes to development of hyperglycaemia. Nevertheless blood glucose 7 mM was significantly
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