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Background Chronic obstructive pulmonary disease (COPD) could be considered as a new threat for recently diagnosed patients with diabetes. Alternatively, diabetes mellitus could be an autonomous risk, harmfully disturbing the structure of the lung and its function. Patients and methods This work was conducted on 80 patients having acute exacerbation of COPD, comprising 20 controlled diabetic, 20 uncontrolled diabetic, and 40 nondiabetic COPD. The following was done: history taking, full evaluation, laboratory workup [glycated hemoglobin (HbA1C), fasting blood glucose, postprandial glucose, and random blood sugar (RBS)] for diabetic patients, arterial blood gases, evaluation of the duration of ICU stay, the need for mechanical ventilation and its duration, and cultures and sensitivity. Results The present study showed significant differences among the three groups according to the outcome. There was significant correlation between HbA1C and RBS and duration of stay in the ICU in both diabetic groups. In addition, there was significant correlation between HbA1C and the duration of mechanical ventilation in both diabetic groups (P=0.002 and 0.045, respectively). Moreover, there was a significant correlation between HbA1C and RBS on admission and PaCO2 but a significant negative correlation between HbA1C and RBS on admission and PaO2 in both diabetic groups. Pseudomonas aeruginosa and Klebsiella pneumoniae were isolated from 30 and 25% of uncontrolled diabetic patients, respectively, and from 20 and 15% of controlled diabetic patients, respectively. Fungi (candida) and polymicrobial infection were only isolated from uncontrolled diabetic. Conclusion COPD will remain a significant health burden. The uncontrolled diabetes deteriorates the outcome of the patients with acute exacerbation. HbA1C and RBS have statistically significant effect on the prognosis of COPD.