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Lung Problems Linked to
posted May 5, 2005
People with pulmonary health
problems may face a higher risk of developing diabetes, according to a
In findings that echoed previous research, doctors at the Centers for Disease
Control and Prevention (CDC) found that the odds of developing diabetes
increased as certain measures of lung function decreased.
Earl Ford, MD, and David Mannino, MD, of the National Center for Chronic Disease
Prevention and the National Center for Environmental Health, respectively,
pulled data from the National Health and Nutrition Examination Survey
Epidemiologic Follow-Up Study to assess the risk of diabetes relative to lung
function. In all, the study included information on more than 4,800 men and
women aged 25 to 74 who had an initial interview and lung tests, including
spirometry—a measure of the volume and flow of air—between 1971 and 1975. Each
individual had been followed for nearly 20 years afterward.
During the follow-up period, Ford and Mannino learned 443 people became
diabetic, based on verbal reporting, hospitalization or death certificate data.
When comparing measures of lung function to the incidence of diabetes in this
group of patients, Ford and Mannino found that as measures of two lung tests
known as forced expiratory volume (FEV) and forced vital capacity (FVC)
decreased, the odds of contracting diabetes surged.
Forced expiratory volume measures the total amount of air that can be exhaled in
a given number of seconds. Forced vital capacity measures the flow of air in a
given exhalation. This is done by using a spirometer, an instrument into which a
patient is asked to exhale forcefully for 6 seconds or more after inhaling as
much air as possible.2
"Obstructive lung disease was not significantly associated with the incidence of
diabetes, but restrictive lung disease was," wrote the two researchers. "The
association did not differ significantly by smoking status."
Obstructive lung disease and restrictive lung disease are two distinct
pathologies. Restrictive lung disease is caused by a reduction in the amount of
air that your lungs can hold. They become stiff, which limits their ability to
expand when you breathe in. In contrast, obstructive lung disease is due to a
decrease in the amount of air that you can exhale from your lungs caused by
narrowing or blocking of airways. Restrictive lung disease includes ailments
like sarcoidosis and pulmonary fibrosis.3
In contrast, chronic obstructive lung disease, also known as COPD, is a general
term that includes diseases like emphysema and chronic bronchitis. It is
characterized by extensive lung damage, which makes it harder to breathe. It is
the fourth most common cause of death in the United States and is blamed on
cigarette smoking in most cases.4
"Although several prospective studies have found that impaired pulmonary
function may increase the risk for developing diabetes, additional research is
needed to better understand these relationships and their possible
implications," the two physicians in this study wrote.
1. Ford ES, Mannino DM. Prospective association between lung
function and the incidence of diabetes. Diabetes Care 2004 Dec;27(12):2966-70.
2. National Lung Health Education Program (NLHEP). Spirometry. Available at:
http://www.nlhep.org/spirom1.html. Accessed April 28, 2005.
3. Mayo Foundation for Medical Education and Research. Restrictive vs.
Obstructive Lung Disease: What's the Difference? Available at: http://www.mayoclinic.com/invoke.cfm?id=AN00759.
Accessed April 28, 2005.
4. National Heart, Lung and Blood Institute. What is Chronic Obstructive
Pulmonary Disease (COPD)? Available at: http://www.nhlbi.nih.gov/health/dci/Diseases/Copd/Copd_WhatIs.html.
Accessed April 28, 2005.
Source: Diabetes In Control.com.
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