Effect of insulin on airway responsiveness in patients with type 2 diabetes mellitus: A cohort study

Claudio Terzano, Susanna Morano, Daniela Ceccarelli, Vittoria Conti, Gregorino Paone, Angelo Petroianni, Elda Graziani, Anna Carnovale, Mara Fallarino, Alessandra Gatti, Elisabetta Mandosi, Andrea Lenzi

Research output: Contribution to journalArticlepeer-review

Abstract

Background. The correlation between low insulin levels and a decreased sensitivity of the muscarinic receptor has been shown on induced-diabetes animal models. We designed a cohort study with the aim of evaluating the effects of insulin therapy on airway responsiveness (AR) in human patients with type 2 diabetes mellitus. Methods. We enrolled 92 patients with type 2 diabetes who had switched from oral anti-diabetic therapy to treatment by insulin subcutaneous injection. Patients were administered the methacholine challenge test (MCT) at time 0 (pre-insulin therapy) and at intervals of 15, 30, 90, 180, and 360 days after insulin treatment. The decline of forced expiratory volume in 1 second (FEV1)% from baseline (Δ FEV1) in response to inhaled methacholine (MCH) was determined to assess airway hyper-responsiveness (AHR). Results. A total of 81 patients (18 women and 63 men) completed the study. Their mean age was 58± 7 years and the mean duration of disease was 13.5plusmn;7.7 years. The mean decrease of FEV1 at pre-insulin assessment was 2.96± 2.6%. Compared with the pre-insulin value, a significant increase of FEV1 was observed at 15, 30, and 90 days after treatment (6.25%, CI 95% 5.4 to 7.2, p = 0.0005; 7.64%, CI 95% 6.6 to 8.1, p<0.001; 6.45%, CI 95% 5.5 to 7.3, p = 0.0004, respectively), while after 180 and 360 days AR was similar to pre-insulin values (Δ FEV1, 3.62%, CI 95% 2.7 to 3.5 and 3.11%, CI 95% 7.9 to 9.3, respectively). Conclusions. The finding of an increased AR in patients with type 2 diabetes during the first 3 months of insulin therapy may underline the importance of monitoring pulmonary function and respiratory symptoms in patients switching from oral anti-diabetic drugs to insulin therapy, especially in the subset of individuals with respiratory disorders.

Original languageEnglish
Pages (from-to)703-707
Number of pages5
JournalJournal of Asthma
Volume46
Issue number7
DOIs
Publication statusPublished - Sep 2009

Keywords

  • Airway responsiveness
  • Asthma
  • Diabetes mellitus
  • Insulin
  • Methacoline Challenge Test

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Immunology and Allergy
  • Pediatrics, Perinatology, and Child Health

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