Pulmonary Function Reduction in Diabetes Mellitus with and without Chronic Obstructive Pulmonary Disease

Word Count: 200 Text Word Count: 2697 Number of Tables and Figures: 6 Running Title; Pulmonary Function in Smokers with Diabetes Mellitus Page 1 of 22 Diabetes Care Diabetes Care Publish Ahead of Print, published online September 11, 2013 ABSTRACT OBJECTIVE: Diabetes mellitus damages major organ systems through disrupted glycemic control and increased inflammation. The effects of diabetes on the lung have been of interest for decades but the modest reduction in pulmonary function and its non-progressive nature have limited its investigation. A recent systematic review found that diabetes was associated with reductions in FEV1, FVC, DLCO and increased FEV1/FVC. They reported pooled results including few smokers. This study will examine measures of pulmonary function in participants with extensive smoking exposure. RESEARCH DESIGN AND METHODS: We examined pulmonary function in participants with >10 pack-years history of smoking with and without diabetes with and without Chronic Obstructive Pulmonary Disease. We measured pulmonary function, exercise capacity and pulmonary related quality of life in 10,129 participants in the Genetic Epidemiology of Chronic Obstructive Pulmonary Disease Study (COPDGene) study. RESULTS: Participants with diabetes were observed to have reduced pulmonary function after controlling for known risk factors and also significant reductions in exercise capacity and quality of life across functional stages of COPD.OBJECTIVE: Diabetes mellitus damages major organ systems through disrupted glycemic control and increased inflammation. The effects of diabetes on the lung have been of interest for decades but the modest reduction in pulmonary function and its non-progressive nature have limited its investigation. A recent systematic review found that diabetes was associated with reductions in FEV1, FVC, DLCO and increased FEV1/FVC. They reported pooled results including few smokers. This study will examine measures of pulmonary function in participants with extensive smoking exposure. RESEARCH DESIGN AND METHODS: We examined pulmonary function in participants with >10 pack-years history of smoking with and without diabetes with and without Chronic Obstructive Pulmonary Disease. We measured pulmonary function, exercise capacity and pulmonary related quality of life in 10,129 participants in the Genetic Epidemiology of Chronic Obstructive Pulmonary Disease Study (COPDGene) study. RESULTS: Participants with diabetes were observed to have reduced pulmonary function after controlling for known risk factors and also significant reductions in exercise capacity and quality of life across functional stages of COPD. CONCLUSIONS: Pulmonary function in patients with ≥10 pack years of smoking and diabetes is reduced and this decrease is associated with significant reductions in activity related quality of life and exercise capacity. Page 2 of 22 Diabetes Care