Postural Variations of Pulmonary Diffusing Capacity in Insulin-Dependent Diabetes Mellitus

Fuso, Leonello; Cotroneo, P; Basso, Salvatore; Rosa, Marino De; Manto, Andrea; Ghirlanda, Giovanni; Pistelli, Riccardo

doi:10.1378/chest.110.4.1009

Cited by 49 publications

(54 citation statements)

References 24 publications

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“…It is well known that in normal subjects the increase in DLCO in the supine, compared to the sitting position, is related to the recruitment of the upper lobe pulmonary capillaries, thus increasing the total volume of pulmonary blood volume [59,60]. Although normal when measured in sitting position, DLCO did not increase with a change from sitting to supine position in patients with type 1 diabetes, compared to healthy subjects [61]. This observation has been attributed to the lack of ability to increase capillary volume in the supine position because of diabetic microangiopathy.…”

Section: Pulmonary Diffusing Capacity For Carbon Monoxide (Dlco)mentioning

confidence: 82%

“…Initially, it was reported that patients with diabetes had reduced spirometric measures [28]. However, these findings were not confirmed by subsequent studies, which found nearly normal lung volumes in diabetic patients, similar as in control subjects [61]. This led to the rejection of a correlation between lung function and glycemic control or duration of diabetes [30,31].…”

Section: Lung Volumesmentioning

confidence: 98%

“…This observation has been attributed to the lack of ability to increase capillary volume in the supine position because of diabetic microangiopathy. Therefore, measurement of DLCO in postural changes could be a useful and a more sensitive tool than simple measurement of DLCO in sitting position in the early diagnosis of diabetic lung complications [61].…”

Section: Pulmonary Diffusing Capacity For Carbon Monoxide (Dlco)mentioning

confidence: 99%

See 2 more Smart Citations

The Diabetic Lung - A New Target Organ?

Pitocco

Fuso²,

Conte³

et al. 2012

Rev Diabet Stud

Self Cite

145

112

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■ AbstractSeveral abnormalities of the respiratory function have been reported in patients with type 1 and type 2 diabetes. These abnormalities concern lung volume, pulmonary diffusing capacity, control of ventilation, bronchomotor tone, and neuroadrenergic bronchial innervation. Many hypotheses have emerged, and characteristic histological changes have been described in the "diabetic lung", which could explain this abnormal respiratory function. Given the specific abnormalities in diabetic patients, the lung could thus be considered as a target organ in diabetes. Although the practical implications of these functional changes are mild, the presence of an associated acute or chronic pulmonary and/or cardiac disease could determine severe respiratory derangements in diabetic patients. Another clinical consequence of the pulmonary involvement in diabetes is the accelerated decline in respiratory function. The rate of decline in respiratory function in diabetics has been found to be two-to-three times faster than in normal non-smoking subjects, as reported in longitudinal studies. This finding, together with the presence of anatomical and biological changes similar to those described in the aging lung, indicates that the "diabetic lung" could even be considered a model of accelerated aging. This review describes and analyses the current insight into the relationship of diabetes and lung disease, and suggests intensifying research into the lung as a possible target organ in diabetes.

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Section: Pulmonary Diffusing Capacity For Carbon Monoxide (Dlco)mentioning

confidence: 82%

Section: Lung Volumesmentioning

confidence: 98%

Section: Pulmonary Diffusing Capacity For Carbon Monoxide (Dlco)mentioning

confidence: 99%

See 1 more Smart Citation

The Diabetic Lung - A New Target Organ?

Pitocco

Fuso²,

Conte³

et al. 2012

Rev Diabet Stud

Self Cite

145

112

View full text Add to dashboard Cite

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“…Some reports describe decreased volumes and flows in diabetic adults [12,13,14,15], adolescents [9,11] and children [17,18] as compared with control subjects or reference values. Others, conversely, report normal lung volumes and flows in diabetic adults [8,16,32,33], adolescents [9,34] and children [19].…”

Section: Discussionmentioning

confidence: 99%

Diffusing capacity for carbon monoxide in children with type 1 diabetes

et al. 2004

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Aims/hypothesis. Few data are available on lung dysfunction in children with diabetes. We studied the association of pulmonary function variables (flows, volumes and alveolar capillary diffusion) with disease-related variables in children with type 1 diabetes mellitus. Methods. We studied 39 children with type 1 diabetes (mean age 10.9±2.6 years, disease duration 3.6±2.4 years, insulin·kg −1 ·day −1 0.77±0.31) and 30 healthy control children (mean age 10.4±3.0 years). Pulmonary function tests included spirometry, N 2 wash-out and the single-breath diffusing capacity for carbon monoxide (DL CO Conclusions/interpretation. In children with type 1 diabetes, the diffusing capacity diminishes early in childhood and is associated with poor metabolic control. Although low DL CO /V A levels in these children probably reflect pulmonary microangiopathy induced by type 1 diabetes, other factors presumably influencing CO diffusion capacity measurements (e.g. a left shift in HbA 1 c resulting in high O 2 binding and low CO binding) could explain the apparent capillary and alveolar basal membrane dysfunction.Keywords Children · Lung function · Pulmonary gas exchange · Type 1 diabetes mellitus

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“…Fuso and colleagues reported more milder pulmonary capillary blood volume abnormalities in patients with type 1 diabetes using tests of DLCO transfer capacity and capillary blood volume in both the seated and supine positions. 157 Ozmen and co-workers suggested that their failure to show a relationship between DLCO transfer capacity and microalbuminuria, diabetes duration or glycaemic control was probably due to relative insensitivity of the usual clinical method of measuring DLCO transfer capacity.…”

Section: Clinical Studies Of Lung Function In Diabetesmentioning

confidence: 99%

The clinical effectiveness and cost-effectiveness of inhaled insulin in diabetes mellitus: a systematic review and economic evaluation

Black¹,

Cummins²,

Royle³

et al. 2007

Health Technol Assess

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Postural Variations of Pulmonary Diffusing Capacity in Insulin-Dependent Diabetes Mellitus

Cited by 49 publications

References 24 publications

The Diabetic Lung - A New Target Organ?

The Diabetic Lung - A New Target Organ?

Diffusing capacity for carbon monoxide in children with type 1 diabetes

The clinical effectiveness and cost-effectiveness of inhaled insulin in diabetes mellitus: a systematic review and economic evaluation

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