Exp Clin Endocrinol Diabetes 2017; 125(01): 64-69
DOI: 10.1055/s-0042-112219
Article
© Georg Thieme Verlag KG Stuttgart · New York

The Influence of Type 1 Diabetes Mellitus on Pulmonary Function and Exercise Capacity – Results from the Study of Health in Pomerania (SHIP)

Beate Stubbe*
1   Department of Internal Medicine B, Cardiology, Pneumology, Weaning, Infectious Diseases, Intensive Care Medicine, University Medicine Greifswald, Germany
,
Sabine Schipf*
2   Institute for Community Medicine, SHIP/Clinical-Epidemiological Research, University Medicine Greifswald, Germany
,
Christoph Schäper
1   Department of Internal Medicine B, Cardiology, Pneumology, Weaning, Infectious Diseases, Intensive Care Medicine, University Medicine Greifswald, Germany
,
Stephan B. Felix
1   Department of Internal Medicine B, Cardiology, Pneumology, Weaning, Infectious Diseases, Intensive Care Medicine, University Medicine Greifswald, Germany
,
Antje Steveling
3   Department of Internal Medicine A, University Medicine Greifswald, Germany
,
Matthias Nauck
4   Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Germany
,
Henry Völzke
2   Institute for Community Medicine, SHIP/Clinical-Epidemiological Research, University Medicine Greifswald, Germany
,
Henri Wallaschofski
5   Medical Practice, Erfurt, Germany
,
Nele Friedrich
4   Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Germany
,
Ralf Ewert
1   Department of Internal Medicine B, Cardiology, Pneumology, Weaning, Infectious Diseases, Intensive Care Medicine, University Medicine Greifswald, Germany
,
Till Ittermann*
4   Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Germany
,
Sven Gläser*
1   Department of Internal Medicine B, Cardiology, Pneumology, Weaning, Infectious Diseases, Intensive Care Medicine, University Medicine Greifswald, Germany
› Institutsangaben
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Publikationsverlauf

received 05. Oktober 2015
first decision 22. April 2016

accepted 12. Juli 2016

Publikationsdatum:
04. Oktober 2016 (online)

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Abstract

Background: Diabetes mellitus Type 1 (T1DM) is associated with metabolic and microvascular diseases as part of a multi-organ and multi-systemic disorder. The dense network of capillary vessels in the lungs may change during the course of the development of microangiopathy. The connective tissue as well as alveoli may be subjected to non-enzymatic glycosylation of proteins which may in turn affect pulmonary function. Previous studies investigating lung function in patients with type 1 diabetes have only been performed on small numbers of patients. Our study is based on population data of the Study of Health in Pomerania (SHIP).

Objective: To investigate the influence of metabolic control on pulmonary system function and to establish a decreased pulmonary system function as a late complication of T1DM in a population based setting.

Methods: The study is a case matched study with multiple controls based on participants with T1DM (SHIP-DM-1, n=73) and non-diabetics (SHIP-1, n=292) from the population based study of Pomerania. Data on lung function and exercise performance stratified by age, sex, body mass index and smoking habits in participants with T1DM and without diabetes were matched.

Results: Participants with T1DM showed a significantly lower total lung capacity, residual volume and forced vital capacity. The transfer factor for carbon monoxide, the maximum power output and oxygen uptake during exercise were significantly decreased in comparison to the general population without diabetes.

Conclusion: The pattern of abnormal pulmonary function as observed in the present study with a reduction in lung volume parameters and reduced oxygen uptake in participants with T1DM suggests a restrictive type of lung disease caused by an intrinsic lung tissue derangement as well as pulmonary microangiopathy.

* contributed equally to this work.