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COPD treatment case III: COPD with pre-diabetes
Published on February 29, 2016 12 min
A selection of talks on Immunology & Inflammation
Lymphocyte homing: getting lymphocytes to the right place at the right time
- Prof. Ann Ager
- Cardiff University, UK
Hi. Welcome to this third case in the COPD case series. I'm Janwillem Kocks. I'm a general practitioner and an assistant professor at the Department of General Practice at the University Medical Center in Groningen, the Netherlands. And this case will be about a COPD patient with pre-diabetes.
So if you've seen the other two, you will recognize this patient. This is the same lady, 50 years of age, works in a community archive, and she comes to you for her annual review for COPD. And she tells you she has more difficulty, more breathlessness the last months in her work because the carrying of the boxes with stuff in the archive becomes more difficult. And this lady has an FEV1 of 74 percent of predicted, so mild COPD and that sounds with and FEV1/FVC ratio of 68 percent. And she had a course of antibiotics for a lung attack in the last month during the out-of-hours service. She's been smoking for quite some time and has a number of pack years of 35. And she stopped smoking four weeks ago. She's got BMI of 27.8 and a CCQ score of 1.8. You'll notice that this is all the same for all the different cases. And her medication is ipratropium, which she uses about three times a day for the last months at least because of her work. She uses that when walking with friends as well. What's different compared to the other cases is that she's got a high morning glucose level and she got a diabetic nurse in your practice because of this pre-diabetes. And she gets advice for her diet, for her physical activity, and she's trying to reduce her weight.