- Original article
- Open access
- Published:
The incidence of type 2 diabetes in patients with bronchial asthma
The Egyptian Journal of Internal Medicine volume 31, pages 587–592 (2019)
Abstract
Background
The effect of bronchial asthma on development of new-onset type 2 diabetes has not been studied.
Aim
The aim was to study the association of bronchial asthma and its severity with the incidence of type 2 diabetes after 5 years in patients without diabetes at the disease onset.
Patients and methods
A total of 200 consecutive patients with a physician diagnosis of bronchial asthma (120 not known to be diabetic and 80 known to have diabetes) presenting to the outpatient chest clinic in Kasr Alainy Hospital were included. Fasting blood glucose, 2h 75 g oral glucose tolerance test, glycated hemoglobin, and lipid profile were done. Spirometry, blood pressure, BMI, and other risk factors of diabetes were sought.
Results
Of the 120 nondiabetic patients, 30 patients met at least one criterion of prediabetes and 90 patients met at least one criterion of diabetes. Multivariable regression model demonstrated that forced vital capacity (FVC)%, maximal expiratory flow 75%, and inhaled bronchodilators are independent risk factors for elevated glycated hemoglobin, independent of inhaled or oral corticosteroids, family history, blood pressure, BMI, high-density lipoprotein, and triglycerides. Logistic multivariable regression model demonstrated that FVC% and forced expiratory volume in the first second % are independent risk factors for development of new-onset type 2 diabetes (hazard ratio for FVC%: 1.1589, 95% confidence interval: 1.0684–1.2571, P=0.0004; hazard ratio for forced expiratory volume in the first second %: 0.8754, 95% confidence interval: 0.8155–0.9396, P=0.0002).
Conclusion
The incidence of diabetes and prediabetes in patients with bronchial asthma who are not known to have diabetes at disease onset is 75 and 25%, respectively. Poor pulmonary function tests were independently associated with new-onset diabetes in such patients. This association is linked to the severity of asthma and not related to treatment.
References
Thomsen SF, Duffy DL, Kyvik KO, Skytthe A, Backer V. Risk of asthma in adult twins with type 2 diabetes and increased body mass index. Allergy 2011; 66:562–568.
Rodbard HW, Bays HE, Gavin JR, et al. Rate and risk predictors for development of self-reported type-2 diabetes mellitus over a 5-year period: the SHIELD study. Int J Clin Pract 2012; 66:684–691.
Cazzola M, Calzetta L, Bettoncelli G, et al. Asthma and comorbid medical illness. Eur Respir J 2011; 38:42–49.
Cazzola M, Calzetta L, Rogliani P, et al. High glucose enhances responsiveness of human airways smooth muscle via the Rho/ROCK pathway. Am J Respir Cell Mol Biol 2012; 47(4):509–516.
Rogliani P, Calzetta L, Capuani B, et al. Glucagon-like peptide 1 receptor: a novel pharmacological target for treating human bronchial hyperresponsiveness. Am J Respir Cell Mol Biol 2016; 55:804–814.
Song Y, Klevak A, Manson JE, Buring JE, Liu S. Asthma, chronic obstructive pulmonary disease, and type 2 diabetes in the Women’s Health Study. Diabetes Res Clin Pract 2010; 90:365–371.
Gulcan E, Bulut I, Toker A, et al. Evaluation of glucose tolerance status in patients with asthma bronchiale. J Asthma 2009; 46:207–209.
Rachmiel M, Bloch O, Shaul AA, et al. Young patients with both type 1 diabetes mellitus and asthma have a unique IL-12 and IL-18 secretory pattern. Pediatr Diabetes 2011; 12:596–603.
Borish LC, Nelson HS, Corren J, et al. Efficacy of soluble IL-4 receptor for the treatment of adults with asthma. J Allergy Clin Immunol 2001; 107:963–970.
Walsh GM. Emerging drugs for asthma. Expert Opin Emerg Drugs 2008; 13:643–653.
Dandona P, Ghanim H, Monte SV, et al. Increase in the mediators of asthma in obesity and obesity with type 2 diabetes: reduction with weight loss. Obesity (Silver Spring) 2014; 22:356–362.
Yun HD, Knoebel E, Fenta Y, Gabriel SE, Leibson CL, Loftus EV Jr., et al. Asthma and proinflammatory conditions: a population-based retrospective matched cohort study. Mayo Clin Proc 2012; 87(10):953–960.
Author information
Authors and Affiliations
Corresponding author
Additional information
This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
Rights and permissions
This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
About this article
Cite this article
Al-Jarhi, U.M., Mostafa, A.I. & Alnaggar, A.R.L.R. The incidence of type 2 diabetes in patients with bronchial asthma. Egypt J Intern Med 31, 587–592 (2019). https://doi.org/10.4103/ejim.ejim_134_19
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.4103/ejim.ejim_134_19