Effect of Subcutaneous Insulin on Spirometric Maneuvers in Patients with Type 1 Diabetes: A Case-Control Study

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2020Author
Mizab, Chadia
Sauret, Ariadna
Martí, Raquel
López Cano, Carolina
Gutiérrez Carrasquilla, Liliana
Carmona, Paola
González, Jessica
Dalmases, Mireia
Hernández, Cristina
Simó, Rafael
Suggested citation
Sánchez Peña, Enric;
Mizab, Chadia;
Sauret, Ariadna;
Barbé Illa, Ferran;
Martí, Raquel;
López Cano, Carolina;
...
Lecube Torelló, Albert.
(2020)
.
Effect of Subcutaneous Insulin on Spirometric Maneuvers in Patients with Type 1 Diabetes: A Case-Control Study.
Journal of Clinical Medicine, 2020, vol. 9, núm. 5, p. 1249.
https://doi.org/10.3390/jcm9051249.
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Show full item recordAbstract
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.
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Journal of Clinical Medicine, 2020, vol. 9, núm. 5, p. 1249European research projects
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