Summary
We have investigated the influence of diabetes mellitus including the presence of late complications on the pulmonary system. To check this relationship 31 Type 1 (insulin-dependent) diabetic patients (mean age 30.6±5.32 years, mean duration of diabetes 12.9±5.05 years) were admitted into the trial and compared with 18 control subjects. Pulmonary function tests were measured including spirometric parameters, diffusing capacity, specific diffusing capacity and dynamic compliance measured at 20 and 60 breaths per min. No disturbance of the spirometric parameters was observed in the diabetic patients. Diffusing capacity in the diabetic patients with complications was significantly lower than in both the diabetic patients without complications and the control group (81.2±16.2%, 104±13.7%, 99.3±2.8%; p<0.001, p<0.005 respectively). Specific diffusing capacity was significantly lower in the diabetic patients than in the control subjects (80.3±13.1% vs 89.4±12.9%; p<0.05). In the group with late complications specific diffusing capacity was lower than in the group without complications (69.7±9.17%; 87.2±10.7%, respectively; p<0.001). Dynamic compliance at 20 breaths per min in diabetic patients was 84.06±17.08% vs 95.2±11.59% in the control subjects (p<0.05). It was particularly low in the group with late complications 80.6±13.2% and patients with metabolic poor control, 80.3±12.02% (both p<0.005 vs the control group). Dynamic compliance at 60 breaths per min was 60.1±15.0% as compared to 83.2±13.3% in the control group (p<0.001). We conclude that the disturbances of dynamic compliance may be due to the local mosaic abnormalities of lung elasticity, caused by the non-enzymatic glycation of protein. Disturbances in diffusion in diabetic patients confirm the presence of microangiopathy in pulmonary vessels.
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Schnapf BM, Banks RA, Silverstien JJ, Rosenbloom AL, Chesrocon SE, Longhlin GM (1984) Pulmonary function in insulin-dependent diabetes mellitus with limited joint mobility. Amer Rev Respir Dis 130: 930–932
Schulyer MR, Niewoehner DE, Inkley SR, Kohn R (1976) Abnormal lung elasticity in juvenile diabetes mellitus. Amer Rev Respir Dis 113: 37–41
Lange P, Groth S, Mortensen J et al. (1987) Diabetes mellitus and lung function. A population study. Bull Eur de Physiopathol Resp 23 [Suppl 12]: 328 (Abstract)
Sandler M, Bunn A, Stewart R (1986) Pulmonary function in young insulin-dependent diabetic patients. Chest 90: 670–675
Kennedy L, Mehl TD, Riley WT, Merimee TJ (1981) Non-enzymatically glycosylated serum protein in diabetes mellitus. Diabetologia 21: 94–98
Paisey RB, MacFarlane DG, Scheriff JR, Hartog M, Slade RR, White DA (1980) The relationship between blood glycosylated haemoglobin and home capillary glucose levels in diabetics. Diabetologia 19: 31–34
Cotes JE, Hall AM (1970) Transfer factor for the lung; normal values in adults. In: Arcangeli P (ed) Normal values for respiratory function in men. Panimerva Medica, Turin, pp 327–343
Forster RE, Dubois AB, Briscoe WA, Fisher AB (1986) The lung. Physiologic basis of pulmonary function tests. Year Book Medical, Chicago, London
Milic-Emili J, Mead J, Turner JM, Glauser EM (1964) Improved technique for estimating pleural pressure from esophageal balloons. J Appl Physiol 19: 207–211
Quanjer PH (ed) (1983) Standarised lung function testing. Bull Eur Physiopath Resp 19 [Suppl 5]: 1–94
Begin R, Renzetti AD, Bigler AH, Watanabe S (1975) Flow and age dependence of airway closure and dynamic compliance. J Appl Physiol 38: 199–207
Sandler M, Bunn AE, Stewart RI (1987) Cross-section study of pulmonary function in patients with insulin-dependent diabetes. Am Rev Respir Dis 135: 223–229
Schernthaner G, Hauber P, Kummer F, Ludwig H (1977) Lung elasticity in juvenile onset diabetes mellitus. Am Rev Respir Dis 116: 544–546
Cooper BG, Taylor R, Alberti KGMM, Gibson GJ (1990) Lung function in patients with diabetes mellitus. Resp Med 84: 235–239
Weir DG, Jennings PE, Hendy MS, Barnett AH, Sherwood P, Burg E (1988) Transfer factor for carbon monoxide in patients with and without microantiopathy. Thorax 43: 725–726
Kodolova IM, Lysenko IV, Saltykov BB (1982) Changes in the lung in diabetes mellitis. Arkh Patol 44: 35–40
Ofulve F, Kida K, Thurlbeck WM (1988) Experimental diabetes and the lung. I Changes in growth, morphometry and biochemistry. Am Rev Respir Dis 137: 162–166
Ziora D, Strojek K, Sroczynski J, Oklek K (1989) Pulmonary function tests in diabetics. Eur Resp J 2 [Suppl 5]: 336s (Abstract)
Woolcock AJ, Vincent NJ, Macklem PT (1969) Frequency dependence of compliance as a test of obstruction in small airways. J Clin Invest 48: 1097–1106
Levinson RS, Metzger LF, Stanley NN et al. (1977) Airway function in sarcoidosis. Am J Med 62: 51–59
Hamlin CR, Kohn RR, Luschin JH (1975) Apparent accelerated aging of human collagen in diabetes mellitus. Diabetes 24: 902–904
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Strojek, K., Ziora, D., Sroczynski, J.W. et al. Pulmonary complications of Type 1 (insulin-dependent) diabetic patients. Diabetologia 35, 1173–1176 (1992). https://doi.org/10.1007/BF00401373
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DOI: https://doi.org/10.1007/BF00401373