Type 2 diabetes may exacerbate pulmonary dysfunction in CHF patients

מתוך medicontext.co.il
NEW YORK (Reuters Health) – In patients with CHF, comorbid non-insulin-dependent diabetes mellitus (NIDDM) can potentiate the deterioration of lung function and exercise capacity, according to data from what is reportedly the first study to examine this issue.

Cardiac disease can lead to impeded gas transfer, and the same restriction has been documented in adults with insulin-dependent diabetes who do not have cardiac disease, Dr. Marco Guazzi and colleagues, at the Institute of Cardiology, University of Milan, note in the American Journal of Cardiology for January 15.

To investigate whether NIDDM has an additive effect on pulmonary dysfunction in CHF patients, Dr. Guazzi's team evaluated 20 patients with CHF only, 20 patients with both CHF and adequately controlled NIDDM, and a reference group of 20 age- and sex-matched healthy nonsmoking volunteers.

Pulmonary function tests showed that forced expiratory volume in 1 second, maximum voluntary ventilation, vital and total lung capacity, and carbon monoxide diffusion were reduced in the two CHF groups compared with the reference group. This was true with regard to both absolute values and percentages of predicted normal values, the researchers determined.

The variations from normal were significantly greater in the group with comorbid NIDDM than in the group with CHF alone. Furthermore, in the patients with NIDDM, but not in those with CHF alone, there was no overlap with the reference group in terms of individual values of carbon monoxide diffusion.

"Thus, this study suggests a synergistic alteration in lung function by the comorbidity," Dr. Guazzi and colleagues remark. They conclude that the findings have "significant clinical implications" and should stimulate further research "regarding prognosis and therapy of this not unusual comorbidity."

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