• COPD mechanisms
• innate immunity
• respiratory infection

Chakrabarti and colleagues recently reported that hyperglycaemia within 24 h of admission could be used as a predictor of outcome during non-invasive ventilation in decompensated chronic obstructive pulmonary disease (COPD).1 Hyperglycaemia was unrelated to prior oral corticosteroid use in this study, but duration of steroid preceding admission was not reported. Furthermore, as this group included only 18 patients it would be insufficiently powered to detect a modest rise in glucose. Doctors are vigilant to the occasional patient who develops symptomatic hyperglycaemia whilst taking steroids, but …