Effect of Subcutaneous Insulin on Spirometric Maneuvers in Patients with Type 1 Diabetes : A Case-Control Study
Sánchez, Enric (Institut de Recerca Biomèdica de Lleida)
Mizab, Chadia (Institut de Recerca Biomèdica de Lleida)
Sauret, Ariadna (Institut de Recerca Biomèdica de Lleida)
Barbé, Ferran (Centro de Investigación Biomédica en Red de Enfermedades Respiratorias)
Martí, Raquel (Institut de Recerca Biomèdica de Lleida)
López-Cano, Carolina (Institut de Recerca Biomèdica de Lleida)
Hernández, Marta (Institut de Recerca Biomèdica de Lleida)
Gutiérrez-Carrasquilla, Liliana (Institut de Recerca Biomèdica de Lleida)
Carmona, Paola (Centro de Investigación Biomédica en Red de Enfermedades Respiratorias)
González Gutiérrez, Jessica (Centro de Investigación Biomédica en Red de Enfermedades Respiratorias)
Dalmases, Mireia (Centro de Investigación Biomédica en Red de Enfermedades Respiratorias)
Hernández, Cristina (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Simó Canonge, Rafael (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Lecube, Albert (Instituto de Salud Carlos III)
Universitat Autònoma de Barcelona

Date:	2020
Abstract:	In order to compare spirometric maneuvers in adults according to the presence of type 1 diabetes, a case-control study including 75 patients with type 1 diabetes and 75 controls matched by sex, age, and body mass index were designed. In addition, 75 patients with type 1 diabetes were added to examine the potential the impact of subcutaneous insulin therapy on pulmonary function. Lung function measurements were assessed according to the global initiative for chronic obstructive lung disease guidelines. Basal insulin included long-acting insulin analogues and the delivered background insulin in patients with pump therapy. Bolus insulin included rapid-acting insulin analogues and the delivered insulin to cover postprandial hyperglycemias. Patients with type 1 diabetes showed lower spirometric values in comparison to the control group, together with a higher prevalence of forced expiratory volume in the first second (FEV1) <80% (10. 7% vs. 2. 7%, p = 0. 044) and restrictive ventilatory pattern (10. 7% vs. 0%, p = 0. 006) The dose of basal insulin (U/kg/day) showed a negative correlation with forced vital capacity (FVC) (r = −0. 205, p = 0. 012) and FEV1 (r = −0. 182, p = 0. 026). The optimal cut-off value for identifying patients with a restrictive spirometric pattern was 0. 5 U/kg/day of basal insulin. Additionally, basal insulin (U/kg/day) independently predicted the presence of both a restrictive spirometric pattern (OR = 77. 1 (3. 2 to 1816. 6), p = 0. 007) and an abnormal FEV1 (OR = 29. 9 (1. 5 to 562. 8), p = 0. 023). In patients with type 1 diabetes, higher basal insulin dosage seems to be related with an impairment of pulmonary function.
Grants:	Ministerio de Economía y Competitividad PI12/00803 Ministerio de Economía y Competitividad PI15/00260 Instituto de Salud Carlos III PI18/0096
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Basal insulin ; Bolus insulin ; Lung function ; Spirometry ; Type 1 diabetes
Published in:	Journal of clinical medicine, Vol. 9 (april 2020) , ISSN 2077-0383

DOI: 10.3390/jcm9051249
PMID: 32344939

12 p, 975.7 KB

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