The clinical analysis of glycemic control and changes of pulmonary diffusion capacity in elderly type 2 diabetes / 中华老年医学杂志

ABSTRACT

Objective To investigate the effect of blood glucose level on pulmonary diffusion capacity in elderly patients with type 2 diabetes and its clinical significance.Methods Totally 132 older adults with type 2 diabetes were enrolled in this study.According to blood glucose level,the patients were divided into well-controlled group (n =57) and poor controlled group (n =75).Additionally,52 age-matched non-diabetic healthy subjects were selected as control group.Levels of fasting blood glucose (FBG),glycosylated hemoglobin (HbA1c),fasting insulin (FINS) and 2-hour postprandial glucose (2h PG) in the diabetic patients were detected,and homeostasis model assessment of insulin resistance (HOMA IR) was calculated.The patients with type 2 diabetes underwent urinary albumin excretion rate (UAER) detection,fundus examination and nerve conduction velocity test.pulmonary ventilation,diffusion of the lungs for carbon monoxide (DLCO) and DLCO corrected by alveolar volume (DLCO/VA) were examined in all subjects.Results Levels of FBG,2h PG,HbA1c and HOMA-IR were higher in poor-controlled group than in good glycemicwell-controlled group (all P＜0.05).Compared with the control group,body mass index (BMI) was increased in diabetic groups (both P＜0.05).The pulmonary ventilation function in the three groups had no significant differences (P＞0.05).DLCO and DLCO/VA were lower in diabetic groups than in the control group(all P＜0.05).DLCO and DLCO/VA in poor-controlled group were lower than those in well controlled group (both P＜0.05).DLCO and DLCO/VA were lower in patients with microangiopathy score ≥ 2 than those without microangiopathy (both P ＜ 0.05).Multiple liner regression analysis showed that DCLO and DLCO/VA were negatively correlated with HbA1c,HOMA-IR,duration of diabetes and microangiopathy (r=-2.51,-2.35,-2.42,-2.37,-2.41,-2.52,-2.47,-2.36,all P＜0.05).Conclusions The pulmonary diffusion capacity is significantly impaired in elderly patients with type 2 diabetes.Pulmonary diffusion capacity is negatively correlated with the blood glucose level.The lung may be one of the target organs of type 2 diabetes mellitus.