Background and objective: Hyperglycaemia during hospital admission is associated with poor outcomes in patients admitted with acute myocardial infarction, stroke and pneumonia. Less evidence exists for effect of diabetes mellitus (DM) on those admitted with an acute exacerbation of COPD (AECOPD). We proposed that comorbidity with DM is associated with an increased length of stay in patients admitted with AECOPD. Methods: Records of patients admitted with AECOPD during 2007 were reviewed. Data on the presence of diagnosed DM, length of stay and markers of disease severity and other comorbidities were collected. Analysis was performed using generalized estimating equations to adjust for correlation between multiple admissions in some individuals. Log-transformed length of stay and death were the dependent variables. Results: There were 246 admissions in 172 subjects. Diabetes was a comorbid condition in 22% of admissions for AECOPD. There was a trend for increased length of stay and deaths in those with diabetes (geometric mean 7.8 days and 8% mortality respectively) compared with those without diabetes (6.5 days and 4%). However, after adjustment for covariates, the differences were not statistically significant. Conclusions: Taken together with a previous study that revealed a similar trend, our study suggests that comorbid DM prolongs length of stay and increases risk of death in patients with AECOPD. Further studies are now required to elucidate the reasons for these poorer outcomes, in particular whether premorbid glycaemic control or inpatient control is responsible, as these are potentially modifiable factors.

A family history of diabetes and the need for insulin beyond the first 24 h after transplantation are factors identifiable prior to hospital discharge, which predict patients at risk of developing PTDM. In such patients, consideration to minimizing the dose of glucocorticoids should be given where possible.

The neuropeptide galanin mediates its activities through G-protein-coupled receptors, and three receptor subtypes have been described with distinctly different patterns of regional tissue expression. GALR1 is predominantly expressed in basal forebrain, hypothalamus, as well as spinal cord. GALR2 has a wider distribution in brain and is also present in the pituitary gland and peripheral tissues. GALR3 has been found to be widely distributed at low abundance. We examined the distribution of GALR2 in rat brain and pituitary by in situ hybridization histochemistry and found it abundant in regions of hippocampus, piriform and entorhinal cortex, basal nucleus of the accessory olfactory tract, amygdala, hypothalamic nuclei, Purkinje cells, and discrete brainstem nuclei. It is also highly expressed in the intermediate and anterior lobes of the pituitary. Using combined in situ hybridization immunohistochemistry we characterized the neurotransmitter and hormonal phenotype of cells expressing GALR2 mRNA in the hypothalamus and pituitary gland. Our findings suggest GALR2 is a receptor mediating important functions of galanin in the hypothalamic-pituitary axis and may also play a role in hippocampal and cerebellar function.