|Rev Diabet Stud,
The Diabetic Lung - A New Target Organ?
Dario Pitocco1,2, Leonello Fuso2,3, Emanuele G. Conte3, Francesco Zaccardi1, Carola Condoluci3, Giuseppe Scavone1, Raffaele Antonelli Incalzi4, Giovanni Ghirlanda1
1Diabetes Care Unit, Catholic University of Rome, Italy
2Equally contributed to the paper
3Respiratory Disease Unit, Catholic University of Rome, Italy
4Geriatric Medicine, University Campus Bio-Medico, Rome, Italy
Address correspondence to: Dario Pitocco, MD, Servizio di Diabetologia, Policlinico A. Gemelli, L.go A. Gemelli 1, 00168 Roma, Italy, e-mail: firstname.lastname@example.org
Manuscript submitted April 11, 2012; resubmitted April 25, 2012; accepted May 4, 2012.
Keywords: diabetic lung, diabetes, hyperglycemia, respiratory dysfunction, microvascular reserve, ventilatory pump
Several abnormalities of the respiratory function have been reported in patients with type 1 and type 2 diabetes. These abnormalities concern lung volume, pulmonary diffusing capacity, control of ventilation, bronchomotor tone, and neuroadrenergic bronchial innervation. Many hypotheses have emerged, and characteristic histological changes have been described in the "diabetic lung", which could explain this abnormal respiratory function. Given the specific abnormalities in diabetic patients, the lung could thus be considered as a target organ in diabetes. Although the practical implications of these functional changes are mild, the presence of an associated acute or chronic pulmonary and/or cardiac disease could determine severe respiratory derangements in diabetic patients. Another clinical consequence of the pulmonary involvement in diabetes is the accelerated decline in respiratory function. The rate of decline in respiratory function in diabetics has been found to be two-to-three times faster than in normal non-smoking subjects, as reported in longitudinal studies. This finding, together with the presence of anatomical and biological changes similar to those described in the aging lung, indicates that the "diabetic lung" could even be considered a model of accelerated aging. This review describes and analyses the current insight into the relationship of diabetes and lung disease, and suggests intensifying research into the lung as a possible target organ in diabetes.
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