The Association Between Glycaemic State and Spirometric Indices in Ghanaian Individuals with Type 2 Diabetes Mellitus

Abstract

Background: Diabetes mellitus has been inconsistently associated with reduced level of pulmonary function. Inadequate glycemic control, a longer duration of the disease, obesity and markers of microangiopathy may be associated with decreased lung function in the Ghanaian with type 2 Diabetes mellitus. General Aim: To study pulmonary function as assessed by spirometry and factors that influence lung function in a population of Ghanaian type 2 Diabetes mellitus subjects. Methodology: One hundred and eight subjects with type 2 diabetes mellitus and eighty non- diabetic control subjects who had no history of pulmonary disease were made to undergo spirometric testing. The body composition, glycemic control (assessed by the levels of glycated haemoglobin and fasting blood sugar), duration of diabetes, and indices of microvascular disease (neurothesiometry, estimated glomerular filtration rate (eGFR), and microalbuminuria) were determined and their association with the percentage predictive values of vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in one second (FEV 1 ), FEV 1 /FVC ratio and the forced expiratory flow at 25 to 75% of vital capacity (FEF 25–75% ) were studied. Results: The diagnosis of T2DM was associated with lower than predicted levels of pulmonary function. The pattern of lung impairment was principally restrictive. Pulmonary function was negatively associated with impaired glycemic control but was not associated with duration of diabetes. Among subjects with impaired pulmonary function, the lung volumes FVC and FEV 1 positively correlated with the eGFR and negatively with the urine microalbumin levels and vibration perception threshold. Visceral body fat correlated negatively with FVC and FEV 1 . Conclusion: This study supports other larger studies that have showed that diabetes is associated with restrictive pulmonary disorder. It has also provided country relevant data on pulmonary function and related factors which might provide better insight for the management of type 2 Diabetes mellitus in Ghana.