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Study of pulmonary function tests in diabetics with COPD or asthma

G. P. Mishra1, T.M. Dhamgaye2, B.O. Tayade3, B. Fuladi Amol4, S. Agrawal Amit5, D. Mulani Jasmin6
1Department of Chest & TB, Government Medical College, Nagpur, India, 2Department of Chest & TB, BJ Medical College, Pune, India, 3Department of Chest & TB, NKP Salve Medical College, Nagpur, India, 4Dept. of Chest & TB, Government Medical College, Akola, India, 5Resident, Maimonides Medical Center, New York, USA, 6Rural Hospital, Rajegaon, Gondia, Maharashtra, India
[Applied Cardiopulmonary Pathophysiology 16: 299-308, 2012]


Introduction: The diagnosis of obstructive airway disease in diabetic patients may pose difficulties due the superimposition of restriction associated with diabetes on the pure obstructive pattern predominantly found in these patients. Aims: To evaluate the status of pulmonary function in diabetics (NIDDM Non Insulin Dependent Diabetes Mellitus) with COPD (Chronic Obstructive Pulmonary Disease) or asthma. Methods: 45 Subjects (15 Diabetics with COPD, 15 Diabetics with Asthma & 15 healthy non diabetic, non smoking subjects with no chest complaints taken as the control group) underwent clinical evaluation, biochemical assessment of glycemic control, pulmonary function tests (Spirometry, DLCO and plethysmography lung volume measurements). Results: Spirometry showed pure obstruction in 20% patients whereas 66.67% patients had restriction which was confirmed in 20% on plethysmography. COPD patients had decreased DLCO/VA% (% Diffusion Lung Capacity of Carbon Monoxide corrected for Alveolar Volume) (P<0.0001), increased TLC % (Total Lung Capacity) (P<0.05), RV/TLC % (Residual Volume/ Total Lung Capacity %) (P<0.0001) along with increased severity of airflow limitation (measured by FEV1% (Forced Expiratory Volume in 1st second)) which correlated with DLCO/VA % (P<0.05). Asthmatics had near normal DLCO/VA%, TLC%, increased RV/TLC% (P<0.05) & also demonstrated correlation of FEV1% with duration of diabetes (P<0.05) and RV/TLC% (p<0.05) & also of FVC % (Forced Vital Capacity %) with duration of diabetes (P<0.05). Conclusion: Diabetics with COPD or asthma showed variable pulmonary function findings rather than the expected pure obstructive pattern and FEV1% and FVC% decline associated with diabetes might be responsible for these variable spirometric findings in addition to the severity of the airway disease.

Key words: Diabetes, COPD, Asthma, Pulmonary Function Test, DLCO, Spirometry, Plethysmography

Address for correspondence:
Dr. Gyanshankar P. Mishra
Assistant Professor
Dept. Of Chest & TB
TB Ward premises
Government Medical College
Nagpur, Maharashtra, India - 440003
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