Effect of Inhaled Corticosteroids on Clinical Efficacy and Blood Glucose In COPD: A Retrospective Cohort Study

Inhaled corticosteroids (ICS) are commonly used in chronic obstructive pulmonary disease (COPD), but their potential association with hyperglycemia remains unclear. Therefore, evaluating the glycemic safety of ICS in non‑diabetic COPD patients has direct clinical importance for preventing potential metabolic complications during long‑term management. This retrospective cohort study aimed to evaluate whether adding ICS to long‑acting β₂‑agonist (LABA) therapy affects clinical efficacy and glycemic parameters in non‑diabetic COPD patients. A total of 150 hospitalized COPD patients (January 2022-December 2024) were included. Based on their documented treatment regimens, patients were divided into a control group (formoterol monotherapy, n = 75) and an observation group (formoterol/budesonide combination, n = 75). Primary outcomes were FEV₁, FEV₁/FVC, fasting plasma glucose (FPG), and HbA1c. Secondary outcomes included CAT score, liver/kidney function tests, arterial blood gases, bone mineral density (BMD), and adverse reactions. Baseline characteristics were balanced between groups (all P > 0.05). At 12 months, the observation group showed greater improvements in FEV₁ and FEV₁/FVC (both P < 0.01) and a larger reduction in CAT score (P < 0.001) compared with controls. No significant differences were observed in FPG (P = 0.837), HbA1c (P = 0.134), liver/kidney parameters, arterial blood gases, BMD, or adverse event incidence (P = 0.754) between the two groups. In this retrospective cohort of non‑diabetic COPD patients, adding ICS to LABA therapy improved lung function and symptoms without statistically significant effects on blood glucose or other safety parameters. These findings suggest that ICS/LABA combination may be a safe and effective option in carefully selected patients, but further prospective studies are needed to confirm the absence of long‑term glycemic risk.