Unit of Respiratory Disease and Lung Function, Department of Medicine and Surgery, University of Parma, Parma, Italy -
Unit of Respiratory Disease and Lung Function, Department of Medicine and Surgery, University of Parma, Parma, Italy.
Minerva Med. 2023 Feb;114(1):68-73. doi: 10.23736/S0026-4806.22.07742-4. Epub 2022 Feb 9.
Chronic obstructive pulmonary disease (COPD) and diabetes mellitus (DM) are common and chronic disorders. COPD is characterized by persistent respiratory symptoms and airflow limitation due to airway and/or alveolar abnormalities and it is considered currently the fourth leading cause of death worldwide. DM is a systemic disease characterized by a chronic hyperglycemia associated with inflammation and oxidative stress. The relationship between the two conditions is not completely understood and conflicting results are reported in the literature. Many studies have investigated the mechanisms through with the respiratory disease is associated with an increased risk of metabolic condition or whether the incidence risk of COPD in individuals affected by DM is higher. The link between the two chronic conditions has relevant implications in the management of patients affected by the both of them. Respiratory patients should be screened for diabetes mellitus as a frequent comorbidity of lung disease since therapeutic options should be assessed about risk-to-benefit ratios associated with the indication for the steroid use. Furthermore, the role of hyperglycemia on pulmonary function (e.g. infection or inflammatory processes) should be evaluated in DM. Finally, in presence of both diseases potential treatment interactions should be considered. In this overview we explored the common aspects of both clinical chronic illnesses and investigated the interplay between the two conditions.
慢性阻塞性肺疾病（COPD）和糖尿病（DM）是常见的慢性疾病。COPD 的特征是持续性呼吸道症状和气流受限，这是由于气道和/或肺泡异常引起的，目前被认为是全球第四大致死原因。DM 是一种全身性疾病，其特征是慢性高血糖症与炎症和氧化应激有关。这两种情况之间的关系尚不完全清楚，文献中报告了相互矛盾的结果。许多研究已经探讨了呼吸疾病与代谢状况风险增加之间的机制，或者 DM 患者患 COPD 的发病率是否更高。这两种慢性疾病之间的联系在管理同时患有这两种疾病的患者方面具有重要意义。由于应评估与使用类固醇的适应证相关的风险-获益比，因此应筛选患有肺部疾病的糖尿病患者，因为治疗方案应考虑频繁的合并症。此外，应在 DM 中评估高血糖对肺功能（例如感染或炎症过程）的影响。最后，在存在这两种疾病的情况下，应考虑潜在的治疗相互作用。在这篇综述中，我们探讨了这两种临床慢性疾病的共同方面，并研究了这两种疾病之间的相互作用。
