Kopf S, et al. - In this study performed on patients with prediabetes and type 2 diabetes (T2D), researchers assessed the prevalence of restrictive lung disease (RLD) and interstitial lung disease (ILD) in these patient populations. They found patients with T2D had increased breathlessness and a high prevalence of RLD; this was suggestive of a link between diabetes and fibrosing ILD.

Methods

• This study included 48 nondiabetics, 68 patients with prediabetes, 29 newly diagnosed T2D, and 110 patients with long-term T2D.
• All the study participants were examined for metabolic control, diabetes-related complications, breathlessness, and lung function.
• Multidetector computed tomography (MDCT) and a six-minute walk test (6MWT) was performed on five participants with T2D, breathlessness, and RLD.
• Histological assessment of lung tissue from four patients without diabetes and from three patients with T2D was carried out to detect the presence of pulmonary fibrosis.

Results

• Patients with prediabetes and T2D (p < 0.01) both had significantly increased breathlessness in combination with RLD.
• The presence of RLD was noted in 9% of patients with prediabetes, 20% of patients with newly diagnosed T2D, and 27% of patients with long-term T2D.
• An increased risk of RLD was observed in patients with long-term T2D (OR 5.82 [95% CI 1.71–20.5], p < 0.01).
• Findings demonstrated a significant association of RLD with glucose metabolism and albuminuria (p < 0.01); moreover, presence of nephropathy increased the risk of RLD (OR 8.57 [95% CI 3.4–21.9], p < 0.01) vs nondiabetics.
• On MDCT, ILD was detected in four patients, the 6MWT correlated with the extent of ILD, and patients with T2D had fibrosing ILD on histological analysis.