Relationship between Lung Diseases and Diabetes Mellitus

INTRODUCTION: The prevalence of diabetes mellitus (DM) and its high comorbidity makes one think that that much is still unknown about the complex pathogenesis of this chronic disease and its impact on an organism. Besides damaging already studied target organs, such as retina, kidneys, nervous and cardiovascular system, DM can also affect lungs. Pulmonary dysfunction in DM began to interest scientists and practitioners several decades ago, since patients with chronic hyperglycemia often complain of respiratory symptoms and have an increased risk of developing lung diseases. However, for some time, this relationship was forgotten. Currently, this topic has again regained relevance: the role of chronic uncontrolled hyperglycemia, insulin resistance, endogenous contrainsular hormones, metaflammation, and impairment of humoral and innate immunity is discussed in the development of pulmonary dysfunction. There is increase in the number of patients with undiagnosed DM, which imperceptibly leads to damages of the target organs including pulmonary dysfunction. Some pulmonary diseases have common pathogenetic mechanisms with DM, which is of much interest for research. An important task is to understand what pathological process is primary: pulmonary dysfunction or DM. In this review, the relationship between DM, restrictive and obstructive disorders of lung ventilation is considered. Comorbid lung diseases running with restrictive disorders are considered on an example of idiopathic pulmonary fibrosis. An example of a disease with an obstructive component is chronic obstructive pulmonary disease. CONCLUSION: This review permits to make preliminary conclusions about DM being equally associated with both restrictive and obstructive disorders in lung ventilation. Diabetic microangiopathy damages the lung system resulting in pneumopathy. This leads to the idea of a more thorough control of the respiratory function in diabetic patients. Lungs possessing extensive microcirculatory network and large reserve, remain protected against damaging effect of hyperglycemia for a relatively long time compared to other organs. Screening and awareness of interstitial lung diseases associated with diabetes, will significantly reduce lung comorbidity in patients with DM.