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Comparative Study
. 2017 Jul 17;17(1):101.
doi: 10.1186/s12890-017-0443-1.

Type 2 diabetes is associated with an increased prevalence of respiratory symptoms as compared to the general population

F De Santi  1 , G Zoppini  1 , F Locatelli  2 , E Finocchio  2 , V Cappa  2 , M Dauriz  1 , G Verlato  3
Affiliations
Comparative Study

Type 2 diabetes is associated with an increased prevalence of respiratory symptoms as compared to the general population

F De Santi et al. BMC Pulm Med. .

Abstract

Background: To estimate the prevalence of respiratory symptoms in individuals with type 2 diabetes, as compared to the general population.

Methods: Between 2007 and 2010 the screening questionnaire of GEIRD (Gene Environment Interactions in Respiratory Diseases) study was administered to two samples of Verona general population, aged respectively 45-64 years and 65-84 years, and to a convenience sample of individuals with type 2 diabetes, consequently recruited at the local Diabetes Centre. Ninety-four and 165 people with type 2 diabetes, aged respectively 45-64 and 65-84 years, were compared with 676 and 591 subjects in the same age range from the general population. The influence of type 2 diabetes on respiratory symptoms was evaluated by logistic regression models, controlling for sex, age (45-54, 55-64, 65-74, 75-84 years), education level, smoking habits and heavy vehicle traffic exposure and adjusting standard errors of ORs for intra-sample correlation.

Results: Compared to the general population, dyspnoea limiting walking pace on level ground (grade 2 dyspnoea) was more frequently reported by people with type 2 diabetes, irrespective of age (p < 0.001), while self-reported chronic cough/phlegm was more common in those aged 45-64 years (p = 0.02). These results were confirmed by multivariable analysis: compared to their counterparts from the general population, people with type 2 diabetes aged 45-54 years showed an increased risk of reporting grade 2 dyspnoea (OR = 3.92, 95% CI 3.28-4.68) or chronic cough/phlegm (OR = 1.69, 1.60-1.78). Similar figures held significant at older ages (75-84 years), although partially blunted (dyspnoea: OR = 1.79, 1.68-1.91; chough/phlegm: OR = 1.09, 1.03-1.16). As such, the interaction between age class and type 2 diabetes was significant for both respiratory disorders. The proportion of self-reported dyspnoea among individuals with type 2 diabetes significantly increased across incremental body-mass index (BMI), from 15.4 to 25.4% and further to 41.3% respectively in normoweight, overweight and obese patients (p = 0.048).

Conclusions: People with type 2 diabetes more frequently reported grade 2 dyspnoea and chronic cough/phlegm than the general population of the same age, although presenting similar smoking habits. Diabetes appears to anticipate the lung ageing process, recorded in the general population. The increased occurrence of dyspnoea at incremental BMI among individuals with type 2 diabetes may reflect both cardiovascular and respiratory impairment in this high-risk patient population.

Keywords: Ageing; Asthma-like symptoms; Chronic cough/phlegm; Dyspnoea; Eczema; Obesity; Smoking; Type 2 diabetes.

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Conflict of interest statement

Ethics approval and consent to participate

The present study was approved by “Comitato Etico per la Sperimentazione Clinica delle Province di Verona e Rovigo”, Dipartimento Direzione Medica Ospedaliera, Azienda Ospedaliera Universitaria Integrata Verona (approval prot. N. 42,768). All participants gave informed consent.

Consent for publication

Not applicable.

Competing interests

G. Verlato is Section Editor of BMC Pulmonary Medicine, for the Section Epidemiology and Public Health. G. Verlato received financial support from BioMed Central to participate in the 2014 and 2015 Congresses of the European Respiratory Society. G. Verlato is handling a grant for the clinical stage of the GEIRD study, given to the late Roberto de Marco by Chiesi Farmaceutici S.p.A. All remaining authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Odds ratios (ORs) of reporting chronic cough/phlegm in the general population (blue columns) and in individuals with type 2 diabetes (red columns) as a function of age class. Columns are ORs, bars are 95% confidence intervals. ORs were computed by a logistic regression model, controlling for sex, age, education level, smoking habits and exposure to heavy vehicle traffic
Fig. 2
Fig. 2
Odds ratios (ORs) of reporting mMRC grade 2 dyspnoea in the general population (blue columns) and in individuals with type 2 diabetes (red columns) as a function of age class. Columns are ORs, bars are 95% confidence intervals. ORs were computed by a logistic regression model, controlling for sex, age, education level, smoking habits and exposure to heavy vehicle traffic
See this image and copyright information in PMC

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