Visit-to-visit glycemic variability is associated with lung function variables and lung function impairment in individuals with type 2 diabetes

Glycemic variability (GV) is an emerging biomarker of glycemic control and may be a predictor for lung function impairment in persons with type 2 diabetes mellitus (T2DM). However, the associations between GV and lung function variables and lung function impairment have not been fully evaluated. The objective of this study was to assess the associations of glycemic variability (GV) with lung function impairment in persons with T2DM. A follow-up study was conducted on the data of 3,108 subjects collected from 2001 to 2020 using the diabetes care management program database in Taiwan. GV in fasting plasma glucose (FPG) was calculated using standard deviation (SD), average real variability (ARV), coefficient of variation (CV), variability independent of the mean (VIM), and slope of 1-year repeated measurements. A ratio of forced expiratory volume in 1 s (FEV1) to forced vital capacity (FVC) less than 0.70 was used to define lung function impairment. Multivariable linear and logistic regression models were applied to explore the relationships of GV with lung function variables and lung function impairment. A total of 359 (11.6%) subjects were defined as having lung function impairment. After multivariable adjustment, FPG-SD, FPG-CV, FPG-AVR, FPG-VIM and were found to be negatively linked with FEV1, % predicted FEV1, and FVC but not FEV1/FVC. Relative to those for the first tertile, the odds ratios (ORs) of lung function impairment for the second and third tertiles were 1.37 (95% confidence interval [CI]: 1.01, 1.87) and 1.51 (1.10, 2.08) for FPG-CV, respectively; 1.59 (1.16, 2.17) and 1.73 (1.24, 2.40) for FPG-SD, respectively; and 1.57 (1.15, 2.13) and 1.69 (1.22, 2.33) for FPG-AVR, respectively. GV, measured by CV, SD, VIM, and VIM, is linked with lung function impairment and all lung function variables, except for FEV1/FVC ratio. GV may serve as a useful biomarker for assessing lung function impairment in persons with T2DM.