Poorly controlled Type 2 diabetics have decreased lung function
MedWire News: Patients with Type 2 diabetes who have poor glycemic control have reduced pulmonary function compared with their well-controlled peers, suggest study findings.
The researchers believe this may be caused by high levels of inflammatory mediators.
Rodolfo Dennis (Fundación Cardioinfantil-Instituto de Cardiología, Bogotá, Colombia) and colleagues recruited 495 patients, aged 35-65 years, with Type 2 diabetes, 352 of whom had inadequate glycemic control (glycated hemoglobin [HbA1c] above 7%).
The team measured pulmonary function by obtaining mean values for forced expiratory volume (FEV1), forced vital capacity (FVC), and FEV1/FVC ratio and using predicted "normal" values obtained from Mexican-Americans for comparison purposes.
Writing in the journal BMC Pulmonary Medicine, Dennis et al report that patients with inadequate glycemic control had 75.4 and 121.0 ml lower FEV1 and FVC, respectively, and a 0.013% higher FEV1/FVC ratio than those with adequate glycemic control, all of which were statistically significant differences.
In addition, the inflammatory markers tumor necrosis factor-α, fibrinogen, ferritin, and C-reactive protein, but not interleukin-6, were all significantly increased in inadequately controlled compared with well-controlled Type 2 diabetics.
Discussing the results, the authors say: "Inflammation, microangiopathy, and alterations in lung matrix proteins may all play a role."
They explain: "The first mechanism tends to unify the impairment seen in patients with emphysema with that seen in diabetes and cardiovascular disease; in this context, both Type 2 diabetes and chronic lung disease, such as chronic obstructive pulmonary disease, have been associated with increased levels of low-grade acute and chronic systemic inflammatory mediators and inflammatory markers."
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By Helen Albert