RT Journal Article
SR Electronic
T1 Effect of Glucose Improvement on Spirometric Maneuvers in Patients With Type 2 Diabetes: The Sweet Breath Study
JF Diabetes Care
JO Diabetes Care
FD American Diabetes Association
SP 617
OP 624
DO 10.2337/dc18-1948
VO 42
IS 4
A1 Gutiérrez-Carrasquilla, Liliana
A1 Sánchez, Enric
A1 Barbé, Ferran
A1 Dalmases, Mireia
A1 López-Cano, Carolina
A1 Hernández, Marta
A1 Rius, Ferran
A1 Carmona, Paola
A1 Hernández, Cristina
A1 Simó, Rafael
A1 Lecube, Albert
YR 2019
UL http://care.diabetesjournals.org/content/42/4/617.abstract
AB OBJECTIVE Type 2 diabetes exerts a deleterious effect on lung function. However, it is unknown whether an improvement in glycemic control ameliorates pulmonary function.RESEARCH DESIGN AND METHODS Prospective interventional study with 60 patients with type 2 diabetes and forced expiratory volume in 1 s (FEV1) ≤90% of predicted. Spirometric maneuvers were evaluated at baseline and after a 3-month period in which antidiabetic therapy was intensified. Those with an HbA1c reduction of ≥0.5% were considered to be good responders (n = 35).RESULTS Good responders exhibited a significant improvement in spirometric values between baseline and the end of the study (forced vital capacity [FVC]: 78.5 ± 12.6% vs. 83.3 ± 14.7%, P = 0.029]; FEV1: 75.6 ± 15.3% vs. 80.9 ± 15.4%, P = 0.010; and peak expiratory flow [PEF]: 80.4 ± 21.6% vs. 89.2 ± 21.0%, P = 0.007). However, no changes were observed in the group of nonresponders when the same parameters were evaluated (P = 0.586, P = 0.987, and P = 0.413, respectively). Similarly, the initial percentage of patients with a nonobstructive ventilatory defect and with an abnormal FEV1 decreased significantly only among good responders. In addition, the absolute change in HbA1c inversely correlated to increases in FEV1 (r = −0.370, P = 0.029) and PEF (r = −0.471, P = 0.004) in the responders group. Finally, stepwise multivariate regression analysis showed that the absolute change in HbA1c independently predicted increased FEV1 (R2 = 0.175) and PEF (R2 = 0.323). In contrast, the known duration of type 2 diabetes, but not the amelioration of HbA1c, was related to changes in forced expiratory flow between 25% and 75% of the FVC.CONCLUSIONS In type 2 diabetes, spirometric measurements reflecting central airway obstruction and explosive muscle strength exhibit significant amelioration after a short improvement in glycemic control.