Diabetes and Mortality From Respiratory Diseases: The Japan Collaborative Cohort Study

Abstract

Background: Little evidence is available about the association between diabetes and respiratory disease mortality among Japanese populations. We aimed to explore the association between diabetes and the risk of respiratory diseases mortality through a nationwide prospective study in Japan. Methods: We followed 95,056 participants (39,925 men and 55,131 women) for a median 17.1 years. The information about diabetes status, sociodemographic characteristics, and lifestyles was collected at baseline. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) of mortality from respiratory diseases associated with baseline diabetes status. Results: We identified 2,838 deaths from total respiratory diseases (1,759 respiratory infection, 432 chronic obstructive pulmonary disease, and 647 other respiratory diseases). The association between diabetes and total respiratory disease mortality was statistically significant among women (HR 1.81; 95% CI, 1.39-2.37) but of borderline statistical significance in men (P for interaction <0.01). Besides, there were significant associations between diabetes and mortality from respiratory infection among both men and women (HR 1.39; 95% CI, 1.10-1.76 and HR 2.30; 95% CI, 1.71-3.11, respectively; P for interaction <0.001). However, we failed to detect any statistically significant association between diabetes and COPD mortality. Moreover, the subgroup analysis revealed that the association between diabetes and total respiratory disease mortality was stronger in never smokers when compared with ever smokers (P for interaction = 0.02). Conclusions: Significant association was observed between diabetes and the risk of total respiratory disease mortality, in particular from respiratory infection. Prevention and control of respiratory diseases, especially respiratory infection, should be paid more attention among people with diabetes in clinical and public health practice.

Medications and medical costs for diabetes patients with or without chronic respiratory disease in Beijing, China: A retrospective study

“…Although men outnumbered women in the diabetes population, we uncovered women as a risk factor for CRD among patients with diabetes, consistent with previous research findings (14,17,22). Men were more affected by severe community-acquired pneumonia (31) due to a higher proportion of smokers (32).…”

“…Our finding showed that 18.95%-20.53% of diabetes patients suffered CRD, which is higher than the overall population prevalence (25). In general, diabetes patients have a significant association with the risk of death from CRD, particularly from respiratory infection (17). Similar studies (18,(26)(27)(28)(29) conducted in different areas also confirmed the link between diabetes and higher risk prevalence and mortality from CRD such as TB, COPD, and obstructive sleep apnea, among others.…”

“…Previous research uncovered that insulin resistance or diabetes may contribute to a decline in lung function (15,16). Wang et al uncovered the significant association between DM patients and the risk of total CRD mortality, in particular, from respiratory infection (17) as well as in tuberculosis (TB) (18), and sleep apnea-hypopnea syndrome (SAHS) (19). A higher risk of pneumococcal disease was observed in DM patients as well (20).…”

Diabetes Mellitus and Gastric Cancer: Correlation and Potential Mechanisms

“…Metabolism-induced oxidative stress may promote epithelial mesenchymal transformation, leading to the accumulation of tumor genes and tumor suppressor gene mutations, promoting gastric mucosal damage and interfering with repair [13]. Furthermore, hyperglycemia can generate more energy through glycolysis and lactic acid pathways, leading to energy balance imbalance, affecting intracellular metabolism and damaging immune function, complement activation, and antioxidant systems [57]. Patients with DM may have increased susceptibility to H. pylori infection and delayed wound healing after infection due to immunosuppression caused by hyperglycemia [58].…”