Type 2 diabetes is associated with an increased prevalence of respiratory symptoms as compared to the general population

Abstract

BackgroundTo estimate the prevalence of respiratory symptoms in individuals with type 2 diabetes, as compared to the general population.MethodsBetween 2007 and 2010 the screening questionnaire of GEIRD (Gene Environment Interactions in Respiratory Diseases) study was administered to two samples of Verona general population, aged respectively 45-64 years and 65-84 years, and to a convenience sample of individuals with type 2 diabetes, consequently recruited at the local Diabetes Centre. Ninety-four and 165 people with type 2 diabetes, aged respectively 45-64 and 65-84 years, were compared with 676 and 591 subjects in the same age range from the general population. The influence of type 2 diabetes on respiratory symptoms was evaluated by logistic regression models, controlling for sex, age (45-54, 55-64, 65-74, 75-84 years), education level, smoking habits and heavy vehicle traffic exposure and adjusting standard errors of ORs for intra-sample correlation.ResultsCompared to the general population, dyspnoea limiting walking pace on level ground (grade 2 dyspnoea) was more frequently reported by people with type 2 diabetes, irrespective of age (p < 0.001), while self-reported chronic cough/phlegm was more common in those aged 45-64 years (p = 0.02). These results were confirmed by multivariable analysis: compared to their counterparts from the general population, people with type 2 diabetes aged 45-54 years showed an increased risk of reporting grade 2 dyspnoea (OR = 3.92, 95% CI 3.28-4.68) or chronic cough/phlegm (OR = 1.69, 1.60-1.78). Similar figures held significant at older ages (75-84 years), although partially blunted (dyspnoea: OR = 1.79, 1.68-1.91; chough/phlegm: OR = 1.09, 1.03-1.16). As such, the interaction between age class and type 2 diabetes was significant for both respiratory disorders. The proportion of self-reported dyspnoea among individuals with type 2 diabetes significantly increased across incremental body-mass index (BMI), from 15.4 to 25.4% and further to 41.3% respectively in normoweight, overweight and obese patients (p = 0.048).ConclusionsPeople with type 2 diabetes more frequently reported grade 2 dyspnoea and chronic cough/phlegm than the general population of the same age, although presenting similar smoking habits. Diabetes appears to anticipate the lung ageing process, recorded in the general population. The increased occurrence of dyspnoea at incremental BMI among individuals with type 2 diabetes may reflect both cardiovascular and respiratory impairment in this high-risk patient population.

Carbohydrate and Lipid Metabolic Profiles Of Tuberculosis Patients With Bilateral Pulmonary Lesions and Mycobacteria Excretion

“…Studies show that many people with type 2 diabetes also suffer from interstitial lung disease. The pro-inflammatory, proliferative, and oxidative properties of hyperglycemia have been shown to have an important role in affecting pulmonary vasculature, airways, and lung parenchyma [3][4][5]. But inflammatory lung diseases also can be a reason of glucose metabolism disorders.…”

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

“…An Australian prospective study which enrolled 1,108,982 individuals with diabetes indicated that standardized pneumonia mortality was 1.22-fold (95% confidence interval [CI], 1.17-1.27) higher in those with type 2 diabetes compared with general populations. 10 Moreover, Soubani et al 11 conducted a retrospective cohort study of ARDS patients, which showed that diabetes may not have effect on the mortality of ARDS patients. However, to our knowledge, little evidence was found about whether presence of diabetes was associated with higher mortality from respiratory diseases among Japanese populations.…”

“… 7 , 8 Thus, the influence of diabetes on the disease-related outcomes still needs further study. Previous studies have demonstrated associations between diabetes and risk of mortality from respiratory diseases, such as chronic obstructive pulmonary disease (COPD), pneumonia, and acute respiratory distress syndrome (ARDS), 9 – 11 yet the results were inconclusive among different studies. Bragg et al 9 found that diabetes was significantly associated with increased mortality from chronic respiratory diseases, mainly COPD, through a nationwide prospective study of 512,869 adults in China (rate ratio 1.29; 95% CI, 1.10–1.51).…”

Epidemiology of Respiratory Problems in Association With Various Risk Factors: A Clinical Study at St. Joseph’s General Hospital

“…When the medical history data of the patients was analyzed with SPSS version 6.0, it showed no significant difference in both respiratory history and history of comorbidities was present between male and female (P > 0.05). People with type 2 diabetes more frequently reported grade 2 dyspnoea and chronic cough/phlegm than the general population of the same age, although presenting similar smoking habits 9 .…”