Increased risk of respiratory diseases in adults with Type 1 and Type 2 diabetes

  • Chelsey George
    Affiliations
    Department of Epidemiology, School of Public Health, West Virginia University, Morgantown, WV, United States
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  • Alan M. Ducatman
    Affiliations
    Department of Occupational and Environmental Health, School of Public Health, West Virginia University, Morgantown, WV, United States
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  • Baqiyyah N. Conway
    Correspondence
    Corresponding author at: 11937 US Hwy 271, Suite BMR 110.2, Tyler, TX 75708-3154, United States.
    Affiliations
    Department of Epidemiology, School of Public Health, West Virginia University, Morgantown, WV, United States

    Department of Epidemiology and Biostatistics, School of Rural and Community Health, University of Texas Health Science Center at Tyler, Tyler, TX, United States
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      Abstract

      Aims

      Diabetes is linked with decreases in lung elasticity and in capacity to transfer carbon monoxide. Systemic inflammation, a common concern with diabetes, may contribute to airflow obstruction. We examined the association of self-reported diabetes with self-reported respiratory diseases (RDs) among 53,146 adults from the C8 Health Project.

      Methods

      Participants were categorized into three groups: Type 1 (T1D, n = 781), Type 2 (T2D, n = 4277), or no diabetes (n = 48,088). ORs (95% CIs) for the association of diabetes with four RDs were computed: emphysema, chronic obstructive pulmonary disease (COPD), chronic bronchitis (CB), and asthma. Covariates controlled for were age, sex, estimated glomerular filtration rate, C-reactive protein, smoking history, BMI, and perfluorooctonaoic acid (C8).

      Results

      RDs were present in 26%, 21% and 13% of persons with T1D, T2D, and no diabetes, respectively. In multivariable analyses, persons with T1D were 62% more likely to have any RD (OR: 1.62, CI: (1.36–1.93)), while those with T2D were 1.3 times as likely (OR: 1.26, CI: 1.15–1.37)). Compared to those without diabetes, in those with T1D and T2D diabetes respectively, ORs (CIs) for COPD were 1.89 (1.38–2.57), 1.45 (1.23–1.71), asthma: 1.51 (1.21–1.87), 1.38 (1.24–1.53), CB: 1.96 (1.57–2.45), 1.35 (1.20–1.52) and emphysema: 1.25 (0.85–1.82), 1.31 (1.10–1.56). Population attributable risks for any RDs associated with a history of smoking were 19%, 30%, and 26% for those with Type 1, Type 2, and no diabetes respectively.

      Conclusions

      Diabetes, more so in T1D, appears to increase RD risk. Smoking is an important risk factor, but not as informative in Type 1 diabetes.
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