Pulmonary Function in Non-Insulin-Dependent Diabetes mellitusMarvisi M.a · Bartolini L.a · del Borrello P.a · Brianti M.a · Marani G.a · Guariglia A.a · Cuomo A.b
aDepartment of Internal Medicine, Cortemaggiore Hospital, Piacenza, and bDepartment of Respiratory Diseases, University of Parma, Italy
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Background: In type I diabetes mellitus, lung function has been investigated in several clinical studies, but there are few data concerning pulmonary function abnormalities in patients with non-insulin-dependent diabetes mellitus (NIDDM). Objectives: The aim of this study was to assess the presence of pulmonary function abnormalities in patients with NIDDM and to verify the possible associations between diabetic renal microangiopathy, retinopathy and diabetes control. Method and Patients: Thirty patients with NIDDM were collected and divided into two similar groups: subjects with retinopathy and/or diabetic glomerulopathy (group 1, n = 15) and patients without any complications (group 2, n = 15). 17 were males and 13 females, aged from 45 to 81 years. They had had diabetes for 3–23 years and were studied at the Division of Internal Medicine, with an outpatient service for diabetic patients. All patients were non-smokers. The presence of diabetic glomerulopathy was determined by measuring the 24-hour protein excretion rate using the nephelometric method. The presence of retinopathy was determined by using ophthalmoscopy. Glycosylated hemoglobin was measured as an indicator of glycemic control. We performed a global spirometry and measured pulmonary diffusion capacity by the single-breath method corrected by alveolar volume. Results: We found a significant reduction in lung diffusion capacity for carbon monoxide (DLCO) in the group of patients with other signs of diabetic microangiopathy (p < 0.005) and a significative correlation between DLCO and the grade of albuminuria (r = –0.83, p < 0.001). Conclusions: Pulmonary function abnormalities, in particular a reduction in diffusion capacity, are common in patients with NIDDM and signs of diabetic microangiopathy. A possible explanation is related to an impaired pulmonary microvasculature and alveolar epithelial basal lamina.
© 2001 S. Karger AG, Basel
- Sandler M: Is the lung a target organ in diabetes mellitus? Arch Intern Med 1990;150:1385–1388.
- Sandler M, Bunn AE, Stewart RI: Cross-section study of pulmonary function in patients with insulin dependent diabetes mellitus. Am Rev Respir Dis 1987;135:223–229.
- Schuyler MR, Niewoehner DE, Inkley SR, et al: Abnormal lung elasticity in juvenile diabetes mellitus. Am Rev Respir Dis 1976;113:37–41.
- Cooper BG, Taylor R, Alberti GMM, et al: Lung function in patients with diabetes mellitus. Respir Med 1990;84:235–239.
- Maccioni FJ, Colebatch HJH: Lung volume and distensibility in insulin dependent diabetes mellitus. Am Rev Respir Dis 1991;143:1253–1256.
- Wanke T, Formanek D, Auinger M, et al: Inspiratory muscle performance and pulmonary function changes in IDDM. Am Rev Respir Dis 1991;143:97–100.
- Oulhen P, Barthelemy L, Bellet-Barthas M, et al: Respiratory function study on insulin dependent diabetics. Rev Fr Mal Respir 1982;10:213–224.
- Weir DC, Jennings PE, Hendy MS, et al: Transfer factor for carbon monoxide in patients with diabetes with and without microangiopathy. Thorax 1988;43:725–726.
Strojek K, Ziora D, Sroczynski JW, et al: Pulmonary complications of type 1 diabetic patients. Diabetologia 1992,35:1173–1176.
- Vracko R, Thorning D, Huang TW: Basal lamina of alveolar epithelial and capillaries. Quantitative changes with aging and diabetes mellitus. Am Rev Respir Dis 1979;120:973–983.
Kodolova IM, Lysenco LV, Saltykov BB: Changes in the lung in diabetes mellitus. Arkh Patol 1982;44:35–40.
- Weynand B, Jonckheere A, Frans A, et al: Diabetes mellitus induces a thickening of the pulmonary basal lamina. Respiration 1999;66:14–19.
- Minette Ph, Buysschaert M, Rahier J, et al: Pulmonary gas exchange in life-long nonsmoking patients with diabetes mellitus. Respiration 1999;66:20–24.
- Isotani H, Nakamura Y, Kameoka K, Tanaka K, Furukawa K, Kitaoka H, Ohsawa N: Pulmonary diffusion capacity, serum angiotensin-converting enzyme activity and the angiotensin-converting enzyme gene in Japanese non-insulin dependent diabetes mellitus patients. Diabetes Res Clin Pract 1999;43:173–177.
- Chukwuna C: Type 2 diabetes nephropathy in perspective. J Diabetes Complications 1995;9:55–67.
- American Thoracic Society: Single breath carbon monoxide diffusing capacity (transfer factor). Recommendation for a standard technique. Am Rev Respir Dis 1987;136:1299–1307.
Ofulue F, Thurlbeck MW: Experimental diabetes and the lung. Am Rev Respir Dis 1988;138:284–289.
- Fuso L, Cotroneo P, Basso S, et al: Postural variations of pulmonary diffusion capacity in insulin dependent diabetes mellitus. Chest 1996; 110:1009–1013.
- Ljubic S, Metelko Z, Car N, et al:. Reduction of diffusion capacity for carbon monoxide in diabetic patients. Chest 1998;114:1033–1035.
- Lipscomb DJ, Patel K, Hughes JMB: Interpretation of increase in the transfer factor coefficient for carbon monoxide (DLCO/VA or KCO). Thorax 1978;33:728–733.
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