Pulmonary function tests in type 2 diabetes mellitus and their association with glycemic control and duration of the disease

Abstract

Background:Pulmonary complications of diabetes mellitus (DM) have been poorly characterized. Some authors have reported normal pulmonary functions and even concluded that spirometry is not at all necessary in diabetic patients. Some studies have shown abnormal respiratory parameters in patients of DM. Moreover, the duration of DM and glycemic control have varied impact on the pulmonary functions.Aims and Objectives:The study was undertaken to analyze the pulmonary function parameters in diabetic patients and compare them with age and gender matched healthy subjects. We correlated forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) in diabetic patients with duration of the disease and glycosylated hemoglobin (HbA1c).Materials and Methods:Pulmonary function tests (PFTs) were recorded in 60 type 2 diabetic male patients and 60 normal healthy male controls aged 40-60 years by using Helios 702 spirometer. The PFTs recorded were - FVC, FEV1, FEV1/FVC, FEF25, FEF50, FEF75, FEF25–75, FEF0.2–1.2, and peak expiratory flow rate (PEFR). HbA1c of all the patients was estimated by ion exchange resin method, which is a very standard method of estimation. PFTs of diabetic patients and controls were compared by applying Student′s unpaired t test. Associations between FVC and FEV1 and HbA1c and duration of illness in diabetic patients were analyzed by applying Pearson′s coefficient.Results:The PFTs were significantly decreased in diabetic patients compared with the healthy controls except FEV1/FVC. There was no correlation found between FVC and FEV1 and duration of illness as well as HbA1c.Conclusion:DM being a systemic disease, which also affects lungs causing restrictive type of ventilatory changes probably because of glycosylation of connective tissues, reduced pulmonary elastic recoil and inflammatory changes in lungs. We found glycemic levels and duration of disease are probably not the major determinants of lung pathology, which requires further research.

Assessment of Lung Function by Spirometry and Diffusion Study and Effect of Glycemic Control on Pulmonary Function in Type 2 Diabetes Mellitus Patients of the Eastern India

“…India [6][7][8][9]. The wide range of geographical and climatic conditions in a large country such as India may be associated with regional differences in lung function.…”

Onset of diabetes modulates the airway smooth muscle reactivity of guinea pigs: role of epithelial mediators

“…A growing mass of data indicates a correlation of diabetes mellitus with lung dysfunction (6,7,8). Previous experimental studies have reported that diabetes attenuates the bronchomotor response as a result of decrease in sensory neuropeptide release (9).…”

Chronic Obstructive Pulmonary Disease and Diabetes Mellitus: A Systematic Review of the Literature

“…glycosylation of the connective tissues, reduced pulmonary elastic recoil, increased muscle weakness and/or inflammation), which can result in restrictive alterations. In this regard, studies have demonstrated that pulmonary function tests are significantly decreased in subjects with T2DM in comparison to healthy controls [18,19,20]; this might be the result of direct exposure to elevated blood sugar [21,22] (table 1). In line with this, it was reported that metabolic syndrome, insulin resistance and systemic inflammation constitute important risk factors for reduced lung function in healthy, nonsmoking subjects [23], which suggest that even in the absence of smoking, diabetes can lead to similar effects on pulmonary function.…”