Journal des pratiques avancées en soins infirmiers

Diabetes Mellitus and Airway Obstruction: Is there an Association?

Abstract

Tina L, Andriopoulos P, Geogantas P

Background: The incidence of Diabetes mellitus is increasing rapidly, with type 2 diabetes making up to 90% of the cases. Whether diabetes interferes with lung function is unknown. Aim of this study is to evaluate lung function of diabetic patients.

Materials and Methodology: A cohort of diabetic patients was randomly selected. History and type of diabetes, glycemic control, comorbidities, smoking history was recorded; clinical examination and spirometry was performed.

Results: 62 individuals with type 2 diabetes were enrolled (36 men), aged 64.5 (10.7 Standard Deviation (sd)), Body Mass index 30.1 (6.4 sd), 9.2 years of disease (9.4 sd), HbA1c 7.02% (1.25 sd, 53 mmol/mol, 5.2 sd). 67.7% had arterial hypertension, 14.5% Coronary Heart disease, 54.8% hyperlipidaimia and 16.1% had history of asthmatic symptomatology without any respiratory follow up. 48.3% had smoking history (46.2 pack years) and 20.9% were current smokers. 19.3% had normal spirometry, 30.6% COPD (73.4% mild disease), 6.4% restrictive disorder, 3.2% combined disorder and 40.2% small airway disease (FEF25-75%<60% predicted). In total 74% had obstructive disorder (p<0.001). There was no correlation between sex, smoking, years of diabetes, glycemic control, antidiabetic medications or other comorbidities and obstructive pattern in the spirometry. No patient had evaluated lung function before.

Conclusion: These results prompt to the need of a large cohort study to evaluate the state and evolution of respiratory function in patients with diabetes. The existence of obstructive disorder in the majority of our patients may suggest an endothelial inflammatory process that leads to airway obstruction as a complication of type II diabetes