"Diabetes and Asthma"

Diabetes Interferes in Lung Functions of Asthma and COPD Patients

Research has shown that Diabetes affects the lung function of patients suffering from airway diseases like Asthma and COPD (Chronic Obstructive Pulmonary Disease). The research published in the recent issue of Applied Cariopulmonary Pathophysiology, an international peer-reviewed journal has shown how the pulmonary functions of these patients are affected.

Research has shown that Diabetes affects the lung function of patients suffering from airway diseases like Asthma and COPD (Chronic"Diabetes and Asthma" Obstructive Pulmonary Disease). The research published in the recent issue of Applied Cariopulmonary Pathophysiology . an international peer-reviewed journal has shown how the pulmonary functions of these patients are affected. Dr. Gyanshankar Mishra, Assistant Professor in Pulmonary Medicine from Government Medical College Nagpur is the lead author of the study.

It may be mentioned here that in August 2010 , an article titled “Pulmonary function in diabetes: a metaanalysis.” was published in international journal CHEST. The authors then had concluded that “..it would next be interesting to investigate the potential clinical implications in those patients with diabetes who carry a pulmonary diagnosis, such as COPD or asthma.”

Recently for the first time such a study has been published by researchers from India in medical literature. For the first time a single study has incorporated the advanced pulmonary function testing (Spirometry, DLCO, Plethysmography lung measurements) of diabetics with COPD or Asthma. The findings have shown that Diabetes interferes in the lung functions of asthmatics or COPD patients. Hence only a few of these patients show expected pure obstructive pattern on lung function testing. It is the combined obstruction-restriction pattern more common in these patients. In the asthmatic subgroup, in fact the decline in lung function correlated with the duration of diabetes. Since PFT (pulmonary function test) is the investigation based on which the diagnosis of COPD or Asthma is confirmed as per the existing guidelines, the treating physician should be aware of these variable PFT results in COPD or Asthmatic patients if they are suffering from diabetes or else the patient may be subjected to further evaluation and investigations if this factor is not accounted for.

You can read full article here.

The abstract of this article is given as below.

Introduction:

The diagnosis of obstructive airway disease in diabetic patients may pose difficulties due the superimposition of restriction associated with diabetes on the pure obstructive pattern pre-dominantly found in these patients.
 Aims:
To evaluate the status of pulmonary function in diabet-ics (NIDDM – Non Insulin Dependent Diabetes Mellitus) with COPD (Chronic Obstructive pulmonary Disease) or asthma.
Methods:
45 Subjects (15 Diabetics with COPD, 15 Diabetics withAsthma & 15 healthy non diabetic, non smoking subjects with no chest complaints taken as the control group) underwent clinical evaluation, biochemical assessment of glycemic control, pulmonary function tests (Spirometry, DLCO and plethysmography lung volume measurements).
Results:
Spirometry showed pure obstruction in 20% patients whereas 66.67% patients had restriction which was confirmed in 20% on plethysmography. COPD patients had decreased DLCO/VA% (%Diffusion Lung Capacity of Carbon Monoxide corrected for Alveolar Volume) (P<0.0001), in-creased TLC % (Total Lung Capacity) (P<0.05), RV/TLC % (Residual Volume/ Total Lung capacity %) (P<0.0001) along with increased severity of airflow limitation (measured by FEV1% (Forced Expiratory Volume in 1st second)) which correlated with DLCO/VA % (P<0.05). Asthmatics hadnear normal DLCO/VA%, TLC%, increased RV/TLC% (P<0.05) & also demonstrated correlation of FEV1% with duration of diabetes (P<0.05) and RV/TLC% (p<0.05) & also of FVC % (Forced Vi-tal Capacity %) with duration of diabetes (P<0.05).
Conclusion:
Diabetics with COPD or asthma showed variable pulmonary function findings rather than the expected pure obstructive pattern and FEV1% and FVC% decline associated with diabetes might be responsible for these variable spiro-metric findings in addition to the severity of the airway disease.

Reference: G. P. Mishra, T.M. Dhamgaye , B.O. Tayade , B. Fuladi Amol ,S. Agrawal Amit, D. Mulani Jasmin. Study of Pulmonary Function Tests in Diabetics withCOPD or Asthma. Applied Cardiopulmonary Pathophysiology 16: 299-308, 2012

About the Author: Dr. Gyan Mishra, Assitant Professor in Pulmonary Medicine from India.

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