Research Article

Spirometric Indices in Type 2 Diabetes Mellitus Patients in a Nigerian Tertiary Institution

Adekunle O. Adeoti
Ekiti State University, Nigeria
* Corresponding author
Taiwo H. Raimi
Ekiti State University, Nigeria
Joseph O. Fadare
Ekiti State University, Nigeria
Raphael Ibidapo
Ekiti State University, Nigeria
DOI icon 10.24018/ejmed.2021.3.3.293

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Submitted 2020-05-24
Published 2021-05-07

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Article Main Content

Background: Diabetes mellitus is a non-communicable disease of global health importance. It is a metabolic disorder caused by increased levels of blood glucose over a prolonged period of time. Type 2 diabetes mellitus (T2DM) is usually associated with obesity and insulin resistance. Several studies have also revealed that diabetes mellitus hampers pulmonary functions. This study was aimed at estimating the spirometric indices in type 2 diabetes mellitus patients.

Methods: A cross-sectional study of T2DM patients and apparently healthy control attending the medical outpatient clinic in a tertiary institution in south western Nigeria.

Results: A total of 146 participants with 73 patients with T2DM and 73 control groups. There were no significant differences in the age, body mass index, and gender distribution of the diabetics and control. However, patients with diabetes had higher SBP (133.2±20.17 mmHg vs 111.6±6.5 mmHg p<0.0001), and DBP (78.4±11.8mmHg vs 73.7±6.3 mmHg, p=0.003) when compared to the control. The mean FEV (1.98±0.5 vs 2.09±1.2, p=0.033), FVC (2.35±0.6 vs 2.53±1.3, p=0.045) and FEV/FVC ratio (83.61±7.2 vs 81.14±10.7, p=0.029) were significantly lower in diabetic patients when compared to matched controls. There was no significant difference in the PEF and FEF of both groups.

Conclusion: Type 2 diabetes mellitus patients had significant decrease in their spirometric indices, hence pulmonary function should be included in the periodic comprehensive diabetic check for holistic management.

Keywords: Pulmonary function, Spirometric indices, Diabetes Mellitus, Non-communicable diseases

References

  1. A. M. Ahmed. History of diabetes mellitus. Saudi Med J, vol. 23, no. 4, pp. 373-378. 2002.
     Google Scholar
  2. H. W. Baynest. Classification, Pathophysiology, Diagnosis and Management of Diabetes Mellitus. Journal of Diabetes & Metabolism, vol. 06, no., pp. 2015.
     Google Scholar
  3. N. H. Cho, J. E. Shaw, S. Karuranga, Y. Huang, J. D. da Rocha Fernandes, A. W. Ohlrogge, B. Malanda. IDF Diabetes Atlas: Global estimates of diabetes prevalence for 2017 and projections for 2045. Diabetes Res Clin Pract, vol. 138, no., pp. 271-281. 2018.
     Google Scholar
  4. D. Pitocco, L. Fuso, E. G. Conte, F. Zaccardi, C. Condoluci, G. Scavone, R. A. Incalzi, G. Ghirlanda. The diabetic lung--a new target organ? Rev Diabet Stud, vol. 9, no. 1, pp. 23-35. 2012.
     Google Scholar
  5. W.H.O. Diabetes Fact sheet N312. Geneva: World Health Organization; 2018.
     Google Scholar
  6. DMICC. Genetic basis of type 1 and type2 diabetes, obesity, and their complications.: DMICC; 2014.
     Google Scholar
  7. R. N. Oputa, S. Chinenye. Diabetes in Nigeria – a translational medicine approach. African Journal of Diabetes Medicine, vol. 23, no. 1, pp. 7-11. 2015.
     Google Scholar
  8. A. E. Uloko, B. M. Musa, M. A. Ramalan, I. D. Gezawa, F. H. Puepet, A. T. Uloko, M. M. Borodo, K. B. Sada. Prevalence and Risk Factors for Diabetes Mellitus in Nigeria: A Systematic Review and Meta-Analysis. Diabetes Ther, vol. 9, no. 3, pp. 1307-1316. 2018.
     Google Scholar
  9. S. Ljubic, Z. Metelko, N. Car, G. Roglic, Z. Drazic. Reduction of diffusion capacity for carbon monoxide in diabetic patients. Chest, vol. 114, no. 4, pp. 1033-1035. 1998.
     Google Scholar
  10. E. Ofoegbu, S. Chinenye. National Clinical Practice Guidelines for Diabetes Management in Nigeria. Diabetes Association of Nigeria (DAN), vol., no., pp. 2013.
     Google Scholar
  11. V. P. Singh, A. Bali, N. Singh, A. S. Jaggi. Advanced glycation end products and diabetic complications. Korean J Physiol Pharmacol, vol. 18, no. 1, pp. 1-14. 2014.
     Google Scholar
  12. United Nations General Assembly. Declaration 61/295 on the Rights of Indigenous Peoples. New york: United nations; 2008.
     Google Scholar
  13. M. Sandler. Is the lung a 'target organ' in diabetes mellitus? Arch Intern Med, vol. 150, no. 7, pp. 1385-1388. 1990.
     Google Scholar
  14. J. Giovannelli, P. Trouiller, S. Hulo, N. Cherot-Kornobis, A. Ciuchete, J. L. Edme, R. Matran, P. Amouyel, A. Meirhaeghe, L. Dauchet. Low-grade systemic inflammation: a partial mediator of the relationship between diabetes and lung function. Ann Epidemiol, vol. 28, no. 1, pp. 26-32. 2018.
     Google Scholar
  15. O. L. Klein, J. A. Krishnan, S. Glick, L. J. Smith. Systematic review of the association between lung function and Type 2 diabetes mellitus. Diabet Med, vol. 27, no. 9, pp. 977-987. 2010.
     Google Scholar
  16. G. Sagun, C. Gedik, E. Ekiz, E. Karagoz, M. Takir, A. Oguz. The relation between insulin resistance and lung function: a cross sectional study. BMC Pulm Med, vol. 15, no., pp. 139. 2015.
     Google Scholar
  17. I. Vanidassane, R. Malik, N. Jain. Study of Pulmonary function tests in Type 2 Diabetes Mellitus and their correlation with glycemic control and systemic inflammation. Adv Respir Med, vol., no., pp. 2018.
     Google Scholar
  18. C. A. Benbassat, E. Stern, M. Kramer, J. Lebzelter, I. Blum, G. Fink. Pulmonary function in patients with diabetes mellitus. Am J Med Sci, vol. 322, no. 3, pp. 127-132. 2001.
     Google Scholar
  19. https://select-statistics.co.uk/contact-us/. vol., no., pp.
     Google Scholar
  20. O. Adeyeye, A. Ogbera. Correlates of Abnormal Lung Functions in Type 2 Diabetes in Lagos, Nigeria. CHEST, vol. 146, no. 4, pp. 806A. 2014.
     Google Scholar
  21. W.H.O. Obesity: preventing and managing the global epidemic.Report of a WHO consultation. Geneva: World Health Organization; 2000.
     Google Scholar
  22. M. R. Miller, J. Hankinson, V. Brusasco, F. Burgos, R. Casaburi, A. Coates, R. Crapo, P. Enright, C. P. van der Grinten, P. Gustafsson, R. Jensen, D. C. Johnson, N. MacIntyre, R. McKay, D. Navajas, O. F. Pedersen, R. Pellegrino, G. Viegi, J. Wanger, A. E. T. Force. Standardisation of spirometry. Eur Respir J, vol. 26, no. 2, pp. 319-338. 2005.
     Google Scholar
  23. A. V. Chobanian, G. L. Bakris, H. R. Black, W. C. Cushman, L. A. Green, J. L. Izzo, Jr., D. W. Jones, B. J. Materson, S. Oparil, J. T. Wright, Jr., E. J. Roccella, D. E. Joint National Committee on Prevention, L. Treatment of High Blood Pressure. National Heart, I. Blood, C. National High Blood Pressure Education Program Coordinating. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension, vol. 42, no. 6, pp. 1206-1252. 2003.
     Google Scholar
  24. Z. Anwer, R. K. Sharma, V. K. Garg, N. Kumar, A. Kumari. Hypertension management in diabetic patients. Eur Rev Med Pharmacol Sci, vol. 15, no. 11, pp. 1256-1263. 2011.
     Google Scholar
  25. C. Arauz-Pacheco, M. A. Parrott, P. Raskin. The treatment of hypertension in adult patients with diabetes. Diabetes Care, vol. 25, no. 1, pp. 134-147. 2002.
     Google Scholar
  26. G. L. Bakris, M. Williams, L. Dworkin, W. J. Elliott, M. Epstein, R. Toto, K. Tuttle, J. Douglas, W. Hsueh, J. Sowers. Preserving renal function in adults with hypertension and diabetes: a consensus approach. National Kidney Foundation Hypertension and Diabetes Executive Committees Working Group. Am J Kidney Dis, vol. 36, no. 3, pp. 646-661. 2000.
     Google Scholar
  27. S. F. Akram, E. Asharaf, S. H. Masood, S. M. M. Ali. Association of Pulmonary Functions and HbA1c in Diabetics. PJMHS, vol. 7, no. 2, pp. 306 -309. 2013.
     Google Scholar
  28. J. Zheng, J. Cheng, T. Wang, Q. Zhang, X. Xiao. Does HbA1c Level Have Clinical Implications in Diabetic Patients Undergoing Coronary Artery Bypass Grafting? A Systematic Review and Meta-Analysis. Int J Endocrinol, vol. 2017, no., pp. 1537213. 2017.
     Google Scholar
  29. W. A. Davis, M. Knuiman, P. Kendall, V. Grange, T. M. Davis, S. Fremantle Diabetes. Glycemic exposure is associated with reduced pulmonary function in type 2 diabetes: the Fremantle Diabetes Study. Diabetes Care, vol. 27, no. 3, pp. 752-757. 2004.
     Google Scholar
  30. M. D. Goldman. Lung dysfunction in diabetes. Diabetes Care, vol. 26, no. 6, pp. 1915-1918. 2003.
     Google Scholar
  31. M. Irfan, A. Jabbar, A. S. Haque, S. Awan, S. F. Hussain. Pulmonary functions in patients with diabetes mellitus. Lung India, vol. 28, no. 2, pp. 89-92. 2011.
     Google Scholar
  32. S. A. Meo, A. M. Al-Drees, M. Arif, K. Al-Rubean. Lung function in type 2 Saudi diabetic patients. Saudi Med J, vol. 27, no. 3, pp. 338-343. 2006.
     Google Scholar
  33. N. Agarwal, S. Kaur. Pulmonary function tests in type 2 diabetes mellitus. Archives of Medicine and Health Sciences, vol. 4, no. 1, pp. 2016.
     Google Scholar
  34. S. M. S. Anandhalakshmi, Ganeshkumar, P, Ramachandran, C. Alveolar Gas Exchange and Pulmonary Functions in Patients with Type II Diabetes Mellitus. J Clin Diagn Res, vol. 7, no. 9, pp. 1874-1877. 2013.
     Google Scholar
  35. Aparna. Pulmonary function tests in type 2 diabetics and non-diabetic people -a comparative study. J Clin Diagn Res, vol. 7, no. 8, pp. 1606-1608. 2013.
     Google Scholar
  36. H. Huang, Q. Guo, L. Li, S. Lin, Y. Lin, X. Gong, J. Yao, J. Liang, L. Lin, J. Wen, G. Chen. Effect of type 2 diabetes mellitus on pulmonary function. Exp Clin Endocrinol Diabetes, vol. 122, no. 6, pp. 322-326. 2014.
     Google Scholar
  37. H. Y. Kim, T. S. Sohn, H. Seok, C. D. Yeo, Y. S. Kim, J. Y. Song, Y. B. Lee, D. H. Lee, J. I. Lee, T. K. Lee, S. C. Jeong, M. Hong, H. S. Chae. Prevalence and risk factors for reduced pulmonary function in diabetic patients: The Korea National Health and Nutrition Examination Survey. Korean J Intern Med, vol. 32, no. 4, pp. 682-689. 2017.
     Google Scholar
  38. F. Innocenti, A. Fabbri, R. Anichini, S. Tuci, G. Pettina, F. Vannucci, L. A. De Giorgio, G. Seghieri. Indications of reduced pulmonary function in type 1 (insulin-dependent) diabetes mellitus. Diabetes Res Clin Pract, vol. 25, no. 3, pp. 161-168. 1994.
     Google Scholar
  39. T. Soulis, V. Thallas, S. Youssef, R. E. Gilbert, B. G. McWilliam, R. P. Murray-McIntosh, M. E. Cooper. Advanced glycation end products and their receptors co-localise in rat organs susceptible to diabetic microvascular injury. Diabetologia, vol. 40, no. 6, pp. 619-628. 1997.
     Google Scholar
  40. S. G. Keerthi, B. Sharan, M. Singh, H. K. Bandi, J. K. Preetham. Deterioration of Pulmonary Functions in Type 2 Diabetes Mellitus. Journal of Pharmacy and Biological Sciences, vol. 1, no. 1, pp. 39-43. 2012.
     Google Scholar
  41. C. K. Sreeja, E. Samuel, C. Kesavachandran, S. Shashidhar. Pulmonary function in patients with diabetes mellitus. Indian J Physiol Pharmacol, vol. 47, no. 1, pp. 87-93. 2003.
     Google Scholar