Type-1 diabetes and pulmonary function tests. A meta-analysis

Diabetes and lung function: Linked, but how?

“…Studies of younger adults and children with type 1 diabetes (T1D) also show a reduction in FVC, compared with non-diabetic controls. 6 Does diabetes result in reduced lung function? The study of Choi et al 1 shows an increased rate of decline of FVC in those with diabetes.…”

“…So, when do the effects of diabetes on lung function begin? Studies of younger adults and children with type 1 diabetes (T1D) also show a reduction in FVC, compared with non‐diabetic controls 6 . Does diabetes result in reduced lung function?…”

Pulmonary disease in diabetes

“…2 Metaanalyses of 39 studies of 1274 persons with T1D and 1353 controls and of 66 studies of 11 134 persons with T2D and 48 377 controls both showed 6%-10% lower pulmonary flow rates than those among controls. 3,4 The UK Biobank Study compared 372 093 nondiabetic persons (glycosylated hemoglobin [HbA1c] < 5.7), 53 378 with prediabetes (HbA1c 5.7-6.4), and 27 209 with diabetes (HbA1c ≥ 6.5), adjusting for factors including age, sex, ethnicity, BMI, education, and cigarette and alcohol use; those with prediabetes and diabetes had a 10-year chronic obstructive pulmonary disease (COPD) relative risk of 1.18 (1.13-1.24) and 1.35 (1.24-1.47), respectively, with preexisting diabetes associated with a 1.2-fold greater risk than that among those diagnosed at the time of study entry, and with COPDspecific mortality nearly doubled among those with diabetes diagnosed ≥7 years prior to study entry. 5 In a study of 48 nondiabetic persons, 68 with prediabetes, 29 newly diagnosed T2D, and 110 with long-term T2D, symptoms of breathlessness were present in none, 3%, 10%, and 15% of the respective groups, along with reduction in FVC and pulmonary diffusing capacity.…”

“…Among 2332 initially nondiabetic persons in Malmö, Sweden, homeostatic model assessment of insulin resistance (HOMA‐IR) was elevated at 10‐year follow‐up in approximately one third of those in the lowest quartile of baseline forced vital capacity (FVC), and each 10% greater FVC was associated with a 10% lower likelihood of IR and with 10% lower likelihood of diabetes, adjusted for age, smoking, and body mass index (BMI), while cardiovascular disease (CVD) events significantly increased among those persons with FVC below the median who had developed insulin resistance 2 . Meta‐analyses of 39 studies of 1274 persons with T1D and 1353 controls and of 66 studies of 11 134 persons with T2D and 48 377 controls both showed 6%–10% lower pulmonary flow rates than those among controls 3,4 . The UK Biobank Study compared 372 093 nondiabetic persons (glycosylated hemoglobin [HbA1c] < 5.7), 53 378 with prediabetes (HbA1c 5.7–6.4), and 27 209 with diabetes (HbA1c ≥ 6.5), adjusting for factors including age, sex, ethnicity, BMI, education, and cigarette and alcohol use; those with prediabetes and diabetes had a 10‐year chronic obstructive pulmonary disease (COPD) relative risk of 1.18 (1.13–1.24) and 1.35 (1.24–1.47), respectively, with preexisting diabetes associated with a ~1.2‐fold greater risk than that among those diagnosed at the time of study entry, and with COPD‐specific mortality nearly doubled among those with diabetes diagnosed ≥7 years prior to study entry 5 .…”