To Study Changes in Pulmonary Function Tests in Patients with Type 2 Diabetes Mellitus having Microvascular Complications Compared to the Normal Population

Title: To Study Changes in Pulmonary Function Tests in Patients with Type 2 Diabetes Mellitus Having Microvascular Complications Compared to the Normal Population. Aim: This study aims to analyze the impact of microvascular complications (specifically diabetic retinopathy and nephropathy) in individuals with type 2 diabetes mellitus on their pulmonary function parameters compared to the normal population. Objectives: 1) Identify variations in pulmonary function test (PFT) parameters based on the severity of diabetic retinopathy and nephropathy. 2) Establish a correlation between changes in PFT parameters in type 2 diabetes patients and their HbA1c levels at the time of diagnosis. Methods: The study was conducted at Hind Institute of Medical Sciences, Barabanki, over 18 months, involving 122 participants aged 18-60 years. Participants were divided into two groups: Group A: Non-Diabetic Controls, Group B: Type 2 Diabetic Patients with Microvascular Complications (diabetic retinopathy and/or nephropathy). Assessments included: a) Spirometry to measure PFT parameters. b) Ophthalmic examination to assess diabetic retinopathy c) Urinary albumin assessment to evaluate nephropathy d) Routine blood tests including HbA1c levels. Results: The study found a mixed obstructive-restrictive pattern in lung dysfunction among diabetic individuals, attributed to chronic hyperglycemia and non-enzymatic glycosylation of lung collagen. There was a significant bidirectional relationship observed between abnormal lung function and diabetes, with correlations found between diabetes duration, HbA1c levels, and impaired pulmonary function. Severe diabetic nephropathy and retinopathy correlated strongly with reduced spirometry values, predominantly showing a restrictive impairment pattern in type 2 diabetes. Conclusion: Regular spirometry is crucial for early detection of pulmonary complications in diabetes. It serves as an essential, simple, and reliable tool for managing diabetes-related lung impairments. Emphasizing strict glycemic control and incorporating respiratory muscle strengthening exercises may potentially improve lung function in these patients.