Study on comparison of pulmonary function tests among diabetic and non-diabetic patients in a tertiary care hospital

Mahendrakumar Kalappan, Kannan Rajendran, Prasanna Karthik Suthakaran, Priyanka Thangaraj, Gayathri Ganapathy, Rajendran Karuthodiyil


Background: Diabetes mellitus (DM) is associated with multiple metabolic derangements which in the long term lead to the damage, dysfunction, and failure of different organs like the eyes, kidneys, nerves, heart, and blood vessels, but pulmonary complications of DM have been less addressed. Microangiopathy in lungs can lead to changes in alveolar function which can manifest themselves as pulmonary function abnormalities. Most of the studies on diabetes mellitus and pulmonary function abnormalities had excluded smokers from the study group. In this study, the study design aimed at determining the effects of diabetes mellitus on pulmonary functions of smokers and non-smokers. The objectives of the study were to determine the pulmonary functions of diabetic study patients and non-diabetic controls using spirometry. Also to compare the pulmonary function changes among diabetics and non-diabetics and to compare the pulmonary function changes among diabetics who are smokers and non-smokers.

Methods: Fifty cases, aged more than 35 years, who had DM for more than five years, were selected from the inpatient and outpatient services of a tertiary care hospital. Fifty age and sex matched controls were selected from the healthy non diabetic caregivers of the patients.

Results: Diabetic cases had statistically significant reductions in mean FEV1, mean FVC and mean PEFR (as L/min) when compared to non-diabetics. Among non-smokers, 33.33%of diabetics had abnormal PFTs while only 10% of non-diabetics had abnormal PFTs (P = 0.0498). Among the smokers, 73.91% of the diabetics had abnormal PFT’s while only 33.33%of the non-diabetics had abnormal PFTs (P = 0.0054).

Conclusions: Diabetes mellitus had a significant impact on pulmonary function tests independent of smoking. Diabetes mellitus predominantly causes restrictive changes in the lung function tests.


DM, PFT, Spirometry, Non-smokers, Smokers, Type 2 diabetes

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Kronenberg L, Melmed. Williams textbook of endocrinology. 10th Edition. Elsevier India Publisher. 2003:1428-31.

Vallance P, Calver A. Collier J. The vascular endothelium in diabetes and hypertension. J Hypertens. 1992;10:S25-9.

Sandler M. Is the lung is target organ in diabetes mellitus? Arch Intern Med. 1990;150:1385-8.

Yesil Y, Ugur-Altun B, Turgut N. Phrenic neuropathy in diabetic and prediabetic patients without neuromuscular complaint. Acta Diabetol. 2013;50(5):673-7.

Irfan M, Jabbar A, Haque AS, AwanS, Hussain SF. Pulmonary functions in patients with diabetes mellitus. Lung India. 2011;28:89-92.

Klein O, Meltzer D. Mercedes Carnethon, Jerry A. Krishnan; type II diabetes mellitus is associated with decreased measures of lung function in a clinical setting; Respiratory medicine. 2011;105:1095-8.

Fogarty AW, Jones S, Britton JR, Lewis SA, McKeever TM. Systemic inflammation and decline in lung function in a general population: A prospective study. Thorax. 2007;62:515-20.

Mori H, Okubo M, Okamura M, Yamane K, Kado S, Egusa G. Abnormalities of pulmonary function in patients with non-insulin dependent diabetes mellitus. Intern Med. 1992;31:189-93.

Timothy DME, Knuimann M, Kendall P. Reduced pulmonary function and its association in type-2 Diabetes. Diabetes Research and Clinical Practice. 2000;50:152-9.

Kaminsky DA. Spirometry and diabetes. Diabetes Care. 2004;27:837-8.

Kanyakumari DH, Nataraj SM, Devaraj HS. Correlation of duration of diabetes and Pulmonaryfunction tests in type2 diabetes mellitus patients; Int J Biol Med Res. 2011;2(4):1168-70.

Vojtkova J, Ciljakova M, Michnova Z. Chronic complications diabetes mellitus of related to respiratory system. Pediatrendocrinol diabetes mellitus. 2012;18(3):112-5.

Sinha S, Guleria R, Misra A, Pandey RM, Yadav R, Tiwari S. Pulmonary functions in patients with type 2 diabetes mellitus and correlation with anthropometry and micro vascular complications. Indian J Med Res. 2004;119:66-71.

Kinney GL, Black - Shinn JL, Wan ES, Make B. Regan E and COPD Gene Investigators. Pulmonary Function Reduction in Diabetes with and Without Chronic Obstructive Pulmonary Disease Diabetes Care. 2014;37:389-95.