Background: Pulmonary function impairment among diabetic patients has rarely been studied. Hence, the present study was undertaken to analyze the impact of diabetes and glycemic control on pulmonary function tests (PFT).
Materials and methods: A total of 120 patients were included in a cross-sectional study conducted at a tertiary care center in India. Formerly diagnosed diabetic patients with alteration in blood sugar levels were included. According to the duration of diabetes, there were three groups. Among all the patients, PFT was performed and correlated with the duration of the diabetic condition and glycated hemoglobin (HbA1c).
Results: Significant decrease was observed in the mean value of forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and peak expiratory flow rate (PEFR) in relation to their predicted values with preserved FEV1/FVC ratio, which is indicative of a restrictive pattern of ventilatory dysfunction. A significant negative correlation was found between the duration of diabetes, glycemic control, and PFT impairment.
Conclusion: Long-term diabetes worsens pulmonary function impairment and poor glycemic control. Hence early screening of the respiratory system and strict glycemic control may help to prevent the progression of pulmonary dysfunctions among individuals with diabetes mellitus (DM).
American Diabetes Association Task Force for Writing Nutrition Principles and Recommendations for the Management of Diabetes and Related Complications. American Diabetes Association position statement: evidence-based nutrition principles and recommendations for the treatment and prevention of diabetes and related complications. J Am Diet Assoc 2002;102(1):109–118. DOI: 10.1016/s0002-8223(02)90031-3
Bowden DW, Cox AJ, Freedman BI, et al. Review of the Diabetes Heart Study (DHS) family of studies: a comprehensively examined sample for genetic and epidemiological studies of type 2 diabetes and its complications. Rev Diabet Stud 2010;7(3):188–201. DOI: 10.1900/RDS.2010.7.188
Murea M, Ma L, Freedman BI. Genetic and environmental factors associated with type 2 diabetes and diabetic vascular complications. Rev Diabet Stud 2012;9(1):6–22. DOI: 10.1900/RDS.2012.9.6
Goldman MD. Lung dysfunction in diabetes. Diabetes Care 2003;26(6):1915–1918. DOI: 10.2337/diacare.26.6.1915
Matheus AS, Tannus LR, Cobas RA, et al. Impact of diabetes on cardiovascular disease: an update. Int J Hypertens 2013;2013:653789. DOI: 10.1155/2013/653789
Sandler M, Bunn AE, Stewart RI. Cross-section study of pulmonary function in patients with insulin-dependent diabetes mellitus. Am Rev Respir Dis 1987;135(1):223–229. DOI: 10.1164/arrd.19188.8.131.52
Vracko R, Thorning D, Huang TW. Basal lamina of alveolar epithelium and capillaries: quantitative changes with aging and in diabetes mellitus. Am Rev Respir Dis 1979;120(5):973–983. DOI: 10.1164/arrd.19184.108.40.2063
Fariña J, Furió V, Fernandez-Aceñero MJ, et al. Nodular fibrosis of the lung in diabetes mellitus. Virchows Arch 1995;427(1):61–63. DOI: 10.1007/BF00203738
Schuyler MR, Niewoehner DE, Inkley SR, et al. Abnormal lung elasticity in juvenile diabetes mellitus. Am Rev Respir Dis 1976;113(1):37–41. DOI: 10.1164/arrd.19220.127.116.11
Soulis T, Thallas V, Youssef S, et al. Advanced glycation end products and their receptors co-localise in rat organs susceptible to diabetic microvascular injury. Diabetologia 1997;40(6):619–628. DOI: 10.1007/s001250050725
Bottini P, Scionti L, Santeusanio F, et al. Impairment of the respiratory system in diabetic autonomic neuropathy. Diabetes Nutr Metab 2000;13(3):165–172.
Vojtková J, Ciljakova M, Michnová Z, et al. Chronic complications of diabetes mellitus related to the respiratory system. Pediatr Endocrinol Diabetes Metab 2012;18(3):112–115.
Heimer D, Brami J, Lieberman D, et al. Respiratory muscle performance in patients with type 1 diabetes. Diabet Med 1990;7(5):434–437. DOI: 10.1111/j.1464-5491.1990.tb01419.x
Fuso L, Pitocco D, Longobardi A, et al. Reduced respiratory muscle strength and endurance in type 2 diabetes mellitus. Diabetes Metab Res Rev 2012;28(4):370–375. DOI: 10.1002/dmrr.2284
Yeh HC, Punjabi NM, Wang NY, et al. Cross-sectional and prospective study of lung function in adults with type 2 diabetes: the Atherosclerosis Risk in Communities (ARIC) study. Diabetes Care 2008;31(4):741–746. DOI: 10.2337/dc07-1464
Lange P, Groth S, Kastrup J, et al. Diabetes mellitus, plasma glucose and lung function in a cross-sectional population study. Eur Respir J 1989;2(1):14–19.
Cavan DA, Parkes A, O'Donnell MJ, et al. Lung function and diabetes. Respir Med 1991;85(3):257–258. DOI: 10.1016/s0954-6111(06)80092-2
Ofulue AF, Thurlbeck WM. Experimental diabetes and the lung. II. In vivo connective tissue metabolism. Am Rev Respir Dis 1988;138(2):284–289. DOI: 10.1164/ajrccm/138.2.284
Dennis RJ, Maldonado D, Rojas MX, et al. Inadequate glucose control in type 2 diabetes is associated with impaired lung function and systemic inflammation: a cross-sectional study. BMC Pulm Med 2010;10:38. DOI: 10.1186/1471-2466-10-38
Davis WA, Knuiman M, Kendall P, et al. Glycemic exposure is associated with reduced pulmonary function in type 2 diabetes: the Fremantle Diabetes Study. Diabetes Care 2004;27(3):752–757. DOI: 10.2337/diacare.27.3.752