The Influence Of Type 1 Diabetes Mellitus On Pulmonary Function And Exercise Capacity – Results From The Study Of Health In Pomerania (ship)
Abstract Background: Diabetes mellitus Type 1 (T1DM) is associated with metabolic and microvascular diseases as part of a multi-organ and multi-systemic disorder. The dense network of capillary vessels in the lungs may change during the course of the development of microangiopathy. The connective tissue as well as alveoli may be subjected to non-enzymatic glycosylation of proteins which may in turn affect pulmonary function. Previous studies investigating lung function in patients with type 1 diabetes have only been performed on small numbers of patients. Our study is based on population data of the Study of Health in Pomerania (SHIP). Objective: To investigate the influence of metabolic control on pulmonary system function and to establish a decreased pulmonary system function as a late complication of T1DM in a population based setting. Methods: The study is a case matched study with multiple controls based on participants with T1DM (SHIP-DM-1, n=73) and non-diabetics (SHIP-1, n=292) from the population based study of Pomerania. Data on lung function and exercise performance stratified by age, sex, body mass index and smoking habits in participants with T1DM and without diabetes were matched. Results: Participants with T1DM showed a significantly lower total lung capacity, residual volume and forced vital capacity. The transfer factor for carbon monoxide, the maximum power output and oxygen uptake during exercise were significantly decreased in comparison to the general population without diabetes. Conclusion: The pattern of abnormal pulmonary function as observed in the present study with a reduction in lung volume parameters and reduced oxygen uptake in participants with T1DM suggests a restrictive type of lung disease caused by an intrinsic lung tissue derangement Continue reading >>
The Diabetic Lung - A New Target Organ?
Go to: Introduction Diabetes is the most common of all endocrine diseases and the fourth to fifth leading cause of death in developed countries [1]. Retinopathy, neuropathy, nephropathy, and cardiovascular dysfunction are common diabetic complications, and contribute significantly to morbidity and mortality. These complications are basically caused by vascular damage, which has a central role in the pathophysiology of diabetes [2, 3]. Despite the presence of a large capillary network in the lung, pulmonary complications of diabetes are frequently disregarded. This is mainly because the alveolar-capillary system is characterized by a great microvascular reserve, and pulmonary abnormalities are commonly subclinical in diabetic patient [4]. However, the loss of microvascular reserve in the lung may become clinically important, with increased risk of hypoxia, in case of acute or chronic pathological lung conditions, including pneumonia, chronic obstructive pulmonary disease, and asthma, or fluid overload secondary to heart failure [5]. The association between diabetes and impaired lung function has been frequently observed. Various respiratory disorders have been described in patients with either type 1 and type 2 diabetes [4]. However, the potential clinical implications of this interrelationship have not yet been fully elucidated. This drawback suggests that further research into the lung as a possible target organ in diabetes is needed [6]. The following sections summarize the current state of knowledge on the association of diabetes and lung disease. We learn from the impressive arguments that diabetes can have a decisive influence on lung function, and this has led us to think about the "diabetic lung", and to guide more attention to this important topic. Continue reading >>
Cross-sectional And Prospective Study Of The Association Between Lung Function And Prediabetes
Objectives A growing body of evidence suggests that there is a relationship between impaired lung function and the risk of developing diabetes mellitus (DM). However, it is not known if this reflects a causal effect of lung function on glucose metabolism. To clarify the relationship between lung function and the development of DM, we examined the incidence of newly diagnosed prediabetes (a precursor of DM) among subjects with normal glucose tolerance (NGT) at baseline. Design Primary analysis of an occupational cohort with both cross-sectional and longitudinal data (follow-up duration mean±SD: 28.4±6.1 months). Setting and participants Data were analysed from 1058 men in a cross-sectional study and from 560 men with NGT in a longitudinal study. Outcomes and methods Impaired lung function (per cent predicted value of forced vital capacity (%FVC) or per cent value of forced expiratory volume 1 s/FVC (FEV1/FVC ratio)) in relation to the ratio of prediabetes or DM in a cross-sectional study and development of new prediabetes in a longitudinal study. NGT, prediabetes including impaired glucose tolerance (IGT) and increased fasting glucose (IFG) and DM were diagnosed according to 75 g oral glucose tolerance tests. Measurements and main results %FVC at baseline, but not FEV1/FVC ratio at baseline, was significantly associated with the incidences of DM and prediabetes. Among prediabetes, IGT but not IFG was associated with %FVC. During follow-up, 102 subjects developed prediabetes among those with NGT. A low %FVC, but not FEV1/FVC ratio, was predictive of an increased risk for development of IGT, but not of IFG. Conclusions Low lung volume is associated with an increased risk for the development of prediabetes, especially IGT, in Japanese men. Although there is published evid Continue reading >>
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How Diabetes Affects Your Lungs
Your feet. Your heart. Your kidneys. When you think of the body parts affected by diabetes, these are the ones that likely come to mind. But diabetes also affects another part of your body. And it’s one you use every second of your life: your lungs. If you have diabetes, you are more likely to have certain lung conditions. Diabetes also has an impact on lung function, or how well you breathe. After you receive a diagnosis of type 2 diabetes, your doctor will work with you to determine the best method of treatment, be it medication or insulin injections. But, as Dr. Anthony Cardillo explains, the most effective treatment for type 2 diabetes? Proper diet and exercise. 2017 Healthgrades Operating Company, Inc. All rights reserved. May not be reproduced or reprinted without permission from Healthgrades Operating Company, Inc. Use of this information is governed by the Healthgrades User Agreement. Lung Conditions A study published in Diabetes Care compared the health records of more than 1.8 million California residents with and without diabetes. The research found that adults with either type 1 or type 2 diabetes are: 8% more likely to have asthma 22% more likely to have chronic obstructive pulmonary disease (COPD) 54% more likely to have pulmonary fibrosis, a disease in which scarring in the lungs interferes with your ability to breathe Nearly twice as likely to have been hospitalized for pneumonia Lung Function If you have type 2 diabetes, you have decreased lung function compared with people who don’t have diabetes. Lung function is a measure of how well you’re breathing. It also refers to how well your lungs deliver oxygen to your body. If you have type 2 diabetes, you tend to have 3% to 10% lower lung volumes than adults who do not have the disease. Generally, re Continue reading >>
An Assessment Of Some Lung Function Parameters In Nigerian Males With Diabetes Mellitus
Background: Despite scarce information on the implications of diabetes for pulmonary function, existing evidence suggests that the respiratory system might also be affected by diabetes. We therefore conducted a cross-sectional study of pulmonary function in our male diabetics using spirometric indices. Study design: This was a cross-sectional study of pulmonary function in diabetics. Seventy-six male diabetics aged 27–80 years, mean 55.4±12.6 were studied to determine PEFR, FEV1, FVC and FEV1%FVC which were then compared with predicted values derived from a reference equation. Results: Overall, all lung function parameters/volumes studied were significantly lower in diabetics compared with predicted values P=0.000. Patient’s age correlated negatively with all spirometric indices but there was no significant relationship between lung function and fasting blood sugar, body mass index, or diabetic microvascular complications. Conclusion: The implication of abnormal lung function parameters for respiratory disease in diabetics is unclear. Routine tests of pulmonary function are not presently indicated in our diabetic patients. Background: Treatment of patients with acromegaly caused by pituitary adenoma with somatostatin analogues leads to significant tumour shrinkage in 23–73% of the cases. Although not widely accepted, it has been suggested that the surgical remission rate may be improved by pre-operative treatment with these agents. Aim: To assess whether the degree of tumour shrinkage by lanreotide offered pre-operatively affects the surgical success in acromegalics with pituitary macroadenoma. Patients and methods: Nineteen subjects with active acromegaly (mean GH in GHDC: median 70.0 mU/L; range 11.6–104 – all with high IGF-I) attributed to pituitary macroa Continue reading >>
Correlates Of Abnormal Pulmonary Function Tests In Persons With Type 2 Diabetes Mellitus
Adeyeye OO*, Ogbera OA, Dada AO, Bamisile RT and Brodie Mens A Department of Medicine Lagos State University College of Medicine /Lagos State University Teaching Hospital, Nigeria Citation: Adeyeye OO, Ogbera OA, Dada AO, Bamisile RT, Brodie Mens A (2015) Correlates of Abnormal Pulmonary Function Tests in Persons with Type 2 Diabetes Mellitus. J Pulm Respir Med 5:231. doi:10.4172/2161-105X.1000231 Copyright: ©2015 Adeyeye OO, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Visit for more related articles at Journal of Pulmonary & Respiratory Medicine Abstract Background: This study was conceived to determine the ventilatory pattern of patients with diabetes as well as the effect of body mass index, age, glycosylated haemoglobin, duration of diabetes and blood glucose levels on their pulmonary functions. Method: Two hundred persons with type 2 DM who consented and met inclusion criteria were recruited. The pulmonary function test was carried out using the Spirotrac intuitive version V spirometer made by Vitalograph. This was done according to standard guidelines. Statistic tests employed include Students’ test, correlation coefficient analysis and binary logistic regression. Result: Mean age of the Study participants was 59.6 ± 11.30 years, with more than half 114(57%) of the Diabetics having abnormal ventilatory pattern with 76(38%) having restrictive defect. We noted significant associations between Age (r= -28, p=000), duration of DM (r=-15, p=034) and lung function. A possible predictor of abnormal pulmonary function test was the presence of hypertension (Odds ratio=0.39, Continue reading >>
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Association Between Glycemic State And Lung Function
Recruitment of the Offspring Cohort of the Framingham Heart Study has been previously described (15); this cohort was recruited from 1971 to 1975, enrolling 3,544 children of the Framingham Heart Study Original Cohort and 1,580 spouses of these offspring. Informed consent for participation was obtained from all participants, in accordance with the protocol approved by the institutional review board. The subjects included in this analysis are Offspring Cohort participants who had measurements of the variables of interest at examination 5 (1991–1994). Blood glucose was measured after an overnight fast (A-gent glucose test; Abbott, South Pasadena, CA), assays were run in duplicate, and the intra-assay coefficient of variation was less than 3% (16). DM was defined as a fasting blood glucose of 126 mg/dl or more or treatment with either insulin or an oral hypoglycemic agent (17, 18). Subjects were asked at their initial visit if they had ever smoked cigarettes, and at each subsequent visit they were asked to quantify their smoking if they had smoked regularly in the previous 12 months. Subjects reporting no cigarette use at every visit were classified as never smokers. Those not currently smoking but reporting smoking at any time before examination 5 were classified as former smokers, and those smoking at examination 5 were classified as current smokers. Participants undergo physician examination at each cycle and examiners review symptoms, medications, and medical problems. Based on these data, the physician is asked whether a subject has asthma; subjects classified by the examining physician as “yes” were considered to have asthma, and those classified as “maybe” or “no” were considered not to have asthma. Chronic obstructive lung disease was defined by a FEV Continue reading >>
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Lung Dysfunction In Diabetes
Clear decrements in lung function have been reported in patients with diabetes over the past 2 decades, and many reports have suggested plausible pathophysiological mechanisms. However, at the present time, there are no reports of functional limitations of activities of daily living ascribable to pulmonary disease in patients with diabetes. Accordingly, this review is directed toward a description of the nature of reported lung dysfunction in diabetes, with an emphasis on the emerging potential clinical implications of such dysfunction. More than a quarter-century ago, Schuyler et al. (1) investigated lung function in 11 young (21–28 years old) patients with type 1 diabetes and age-matched normal control subjects. This classic study was the first to report measurements of nearly all the available tests of lung function, including lung elasticity, capacity to transfer carbon monoxide (CO, a surrogate for oxygen transfer capacity), absolute thoracic gas volumes, airflow resistance, and maximal forced spirometric pulmonary function tests (PFTs). As their subjects were lifelong nonsmokers without allergies or lung disease, their finding that lung elastic recoil was decreased in these young patients with diabetes was interpreted to reflect effects of diabetes on lung elastic proteins. This was the first suggestion in the literature that the lung may be a target organ of diabetes. Because the elastic structure of the lung supports the intrathoracic airways and helps to maintain their patency, the authors suggested that patients with diabetes were at risk for developing chronic airflow obstruction. While small changes in lung elastic recoil do not have direct clinical implications, subsequent development of chronic airflow obstruction could incur significant disability due t Continue reading >>
Relationship Between Diabetes And Lung Disease
Diabetes mellitus is an umbrella term for a group of diseases that affects blood sugar, also known as blood glucose, throughout the body. People with diabetes suffer from high amounts of glucose in the blood, which can lead to numerous health complications and unwanted symptoms. Diabetes patients, especially those with type 1 diabetes, have an immune system that responds poorly to fighting infections. This includes fighting lung diseases. Diabetes and Lung Disease As a result of a poorly functioning immune system, people with diabetes are more likely to catch a cold, flu or other illness that will likely require a longer period of time to recover. This can have a significant impact on blood sugar levels and the overall quality of an individual’s health. In fact, several lung diseases can affect diabetes and vice versa. Diabetes can contribute to the development of pneumonia, tuberculosis and chronic obstructive pulmonary disease (COPD). Pneumonia is caused by an infection and consequential inflammation which puts pressure on the lungs and makes it hard to breath. The most common form of pneumonia is caused by a bacterial infection, named Streptococcus pneumonia. Despite popular belief, pneumonia is not caught because of cold weather. When diabetes goes untreated, it can lead to the occurrence of severe breathing difficulties in extreme temperatures associated with pneumonia. Tuberculosis is caused by a bacterial infection and is very contagious. However, not everyone who gets infected with the bacteria develops tuberculosis. For those of us in the US, tuberculosis is fairly rare, although cases have been steadily increasing in recent years. The infection destroys the cells it comes in contact with, and this often happens in the lungs. Diabetes and pulmonary tuberculos Continue reading >>
Pulmonary Function Changes In Type 2 Diabetic Lungs
DOI: Abstract Background: Diabetes is a systemic disease with well-known complications involving eyes, kidneys and nerves. The presence of an extensive pulmonary micro vascular circulation and abundant connective tissue raises the possibility that lung may also be a target organ in diabetes. The purpose of this study was to evaluate pulmonary functions in patients with diabetes mellitus and to determine their correlation with glycemic control, duration of diabetes and its complications. Methods: One hundred type 2 diabetic patients, aged 30-60 years, with 1-20 year duration of diabetes were included in the study. Pulmonary functions were performed with Helios spirometer and Smart PFT-CO transfer equipment. Glycemic levels assessed by measuring FPG, PPG and HbA1c. All patients were evaluated for diabetic microangiopathies: nephropathy (by 24-hour protein excretion), retinopathy (by direct ophthalmoscopy) and neuropathy (by clinical examination). Results: All the spirometry values decreased in diabetic patients of which FVC, FEV1% show significant reduction. Majority have restrictive ventilation pattern. Poor lung functions are in correlation with high sugar levels and long duration. Diffusion capacity significantly reduced in micro vascular complications like retinopathy, nephropathy and neuropathy. Conclusion: The study shows reduced dynamic lung functions in diabetes mellitus. Lung function parameters are negatively correlated to glycemic status and duration of diabetes. Hence strict glycemic control may improve pulmonary functions. References Kumar A, Goel MK, Jain RB, Khanna P, Chaudhary V. India towards diabetes control: Key issues. Australas Med J. 2013;6(10):524-31. King H, Aubert RE, Herman WH. Global burden of diabetes 1995 to 2025. Prevalence, numerical estimat Continue reading >>
Diabetes Therapy To Improve Bmi And Lung Function In Cf
To recruit 150 adult patients with cystic fibrosis related diabetes (CFRD) without fasting hyperglycemia for a multi-center, twelve month, placebo-controlled intervention trial testing the ability of insulin or repaglinide to improve body mass index (BMI) and stabilize pulmonary function in cystic fibrosis (CF). The primary objective of this research is to determine whether treatment with either insulin or an oral diabetes agent that increases endogenous insulin secretion will improve BMI and pulmonary function in cystic fibrosis patients who have diabetes without fasting hyperglycemia. Study Type : Interventional (Clinical Trial) Actual Enrollment : 108 participants Allocation: Randomized Intervention Model: Parallel Assignment Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor) Primary Purpose: Treatment Official Title: Diabetes Therapy to Improve BMI and Lung Function in CF Study Start Date : June 2001 Primary Completion Date : December 2007 Study Completion Date : December 2007 Resource links provided by the National Library of Medicine U.S. FDA Resources Primary Outcome Measures : The primary objective of this research is to determine whether treatment with either insulin or an oral diabetes agent that increases endogenous insulin secretion will improve BMI and pulmonary function in cystic fibrosis patients who have diabetes [ Time Frame: 12 months ] Information from the National Library of Medicine Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies. Diabetic gl Continue reading >>
Lung Conditions
Eating fatty foods and living an unhealthy lifestyle, such as being a smoker, can eventually restrict the lungs' ability to breath, and these negative effects on the lungs tend be more common people with diabetes. The average adult breathing rate at rest is between 12 and 20 breaths per minute. This averages about 8 million breaths per year, and each one is needed to keep us alive. Lung infections and the immune system Diabetes patients, especially those with type 1 diabetes, have an immune system with a lower ability to respond to and deal with infections of any type. This means they are more prone to illnesses than the general population. As a result, people with diabetes are more likely to catch a cold, flu, or other communicable illness and will likely take longer to recover. This can have a significant effect on the blood sugar levels and overall diabetes management. See here for the page on how illness can affect your blood sugars. Two of the biggest lung infections are pneumonia and tuberculosis, which can both cause huge problems to your health. Pneumonia Pneumonia is caused by an infection and consequential inflammation which puts pressure on the lungs and makes it hard to breath. The most common form of pneumonia is caused by a bacterial infection, named Streptococcus pneumoniae. Despite popular belief, pneumonia is not caught because of cold weather. At most, cold weather impairs our immune systems to the point where bacteria already in our lungs can colonise and cause an infection. Other than uncontrolled diabetes, kidney, liver or heart conditions as well as asthma or cystic fibrosis can all increase the risk of catching pneumonia due to their individual effects on the lungs and by making them more susceptible to infections. Symptoms of pneumonia The typica Continue reading >>
Lung Function In Type 2 Saudi Diabetic Patients
Abstract Objectives: To study the effects of type 2 diabetes mellitus on lung function and to determine its severity in relation to duration of disease. Methods: We conducted this study in the Department of Physiology, College of Medicine, King Khalid University Hospital and Diabetic Centre, King Abdul-Aziz University Hospital, Riyadh, Saudi Arabia during the year 2002 - 2004. A group of 32 apparently healthy volunteer male type 2 diabetic patients were randomly selected with an age range from 24-73 years. We matched the diabetic patients with another group of 40 control healthy male subjects in terms of age, height, weight, and socioeconomic status. Both groups met with exclusion criteria as per standard. Spirometry was performed on an Electronic Spirometer (SchillerAT-2 Plus, Switzerland) and results were compared using the 2-tailed student t-test. Results: Diabetic patients showed a significant reduction in the forced vital capacity (FVC), forced expiratory volume in one second (FEV1) and peak expiratory flow (PEF) relative to their matched controls. However, there were no significant difference in the forced expiratory ratio (FEV1/FVC%) and middle half of the FVC (FEF 25-75%) between the groups. Conclusions: Lung function in type 2 diabetic patients is impaired by a decrease in FVC, FEV1 and PEF, as compared to their matched controls. Stratification of results by years of disease showed a dose-response effect on lung function. Continue reading >>
Association Between Pulmonary Function And Development Of Type 2 Diabetes Or Metabolic Syndrome
Can decreased lung function be used as a diabetes predictor? The prevalence of type 2 diabetes is increasing in both developed and developing countries leading to major health and economic burdens for said countries. It is thought that this increase is likely due to increased obesity among populations, but other potential risk factors include impaired lung function. Previous clinical studies have proven that adults with diabetes typically have a lower forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) when compared with non-diabetic patients. Previous studies have also found that there is an inverse relationship between lung function of diabetes patients and blood glucose level, duration and severity of diabetes; independent of smoking status or obesity. Until now the association between lung capacity and type 2 diabetes has not been consistent. This study aims to assess the dose response relationship between FVC and FEV1 for type 2 diabetes patients. This study looked at patients from Australia and China who were randomly selected using random cluster sampling. Patients then completed a questionnaire that included questions about age, sex, education, cigarette smoking, self-reported asthma, chronic obstructive pulmonary disease (COPD) and diabetes. Then blood pressure and body measurements were taken 3 times with the mean of the two closest recordings being used. Patients were classified as overweight if body mass index (BMI) was between 25-29.9, obesity was classified as BMI >30. Spirometry was used to obtain FEV1 and FVC; each patient completed two spirometry attempts while seated. The examination center then processed fasting blood specimens for glucose and lipid levels. Type 2 diabetes was defined using WHO criteria or through self-report Continue reading >>
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Lung Function In Patients With Diabetes Mellitus
Lung function was assessed in 35 nonsmoking adults with insulin dependent diabetes mellitus and 34 matched control subjects. The tests included spirometry, lung volumes, CO transfer factor and maximum respiratory pressures. Additionally, in subjects under 35 years of age (20 patients and 18 controls) measurements of CO transfer factor were obtained during exercise at three different workloads. Random blood glucose and glycosylated haemoglobin were measured and each patient's diabetic history was recorded. The total lung capacity (TLC) in the patients was lower than those recorded for the controls (P<0.05) but there were no significant differences in respiratory muscle strength between the groups. In the young group of patients (<35 years) the transfer factor for CO (TLCO) was similar but the volume corrected transfer coefficient (KCO) was higher as rest than in the controls (P<0.02). The KCO remained high in these patients during exercise. The older patients (<35 years) showed a lower TLCO (P<0·01) with a similar KCO to the controls. The association of a reduction in TLC and higher KCO in the young patients suggests an extraplumonary mechanism of lung volume restriction. This is not attributable to muscle weakness but might be due to limited expansion of the rib cage. In older patients any tendency for KCO to rise may be masked by disease-related changes in the pulmonary microvasculature. Continue reading >>
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