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28-07-2010 | Respiratory | Article

Poorly controlled diabetes linked to reduced lung function

Abstract

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MedWire News: Poor glycemic control is associated with reduced lung function in patients with Type 2 diabetes, study results suggest.

Increased levels of inflammation among patients with poor glycemic control may play a part in the association, says the team.

"Both Type 2 diabetes and chronic lung disease, such as chronic obstructive pulmonary disease (COPD), have been associated with increased levels of low-grade acute and chronic systemic inflammatory mediators and inflammatory markers," explain Rodolfo Dennis (Fundación Cardioinfantil-Instituto de Cardiología, Bogotá, Colombia) and colleagues.

"Until recently, however, few studies had explored lung function among subgroups of diabetic subjects."

For the current study, the researchers recruited 495 patients, aged 35-65 years, with Type 2 diabetes, 352 of whom had inadequate glycemic control, with a glycated hemoglobin (HbA1c) above 7%.

All the participants underwent FEV1 and forced vital capacity (FVC) tests, and their FEV1/FVC ratio was assessed.

The team found that FEV1 and FVC in patients with inadequate glycemic control were 75.4 ml and 121.0 ml lower, respectively, than in those with adequate glycemic control. Furthermore, FEV1/FVC ratio was 0.013% higher in patients with poor compared with adequate glycemic control.

All these differences were statistically significant after accounting for confounding factors, such as smoking, the team notes in the journal BMC Pulmonary Medicine.

In addition, levels of the inflammatory markers tumor necrosis factor-α, fibrinogen, ferritin, and C-reactive protein were all significantly higher in patients with poorly controlled diabetes compared with their well-controlled counterparts.

Dennis and team summarize: "Diabetic subjects with inadequate glucose control have lower pulmonary function than those with adequate control, a difference not explained by usual determinants of lung function."

They add that patients with inadequate control also had significantly higher levels of inflammatory markers that have been implicated in COPD.

"Our findings… should make clinicians more aware of this association and add to the necessity of advising diabetic patients of the need for adequate glucose control."

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

By MedWire Reporters

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