Uppal Pulkita, Mohammed Shaza A, Rajashekar Shriya, Giri Ravindran Suganya, Kakarla Meghana, Ausaja Gambo Musa, Yousri Salama Mustafa, Haidar Ismail Nathalie, Tavalla Pardis, Hamid Pousette
Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.
Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.
Cureus. 2023 Mar 12;15(3):e36047. doi: 10.7759/cureus.36047. eCollection 2023 Mar.
Type 2 diabetes mellitus (T2DM) and asthma are chronic illnesses concomitantly present in a significant percentage of the population. Their comorbidity is associated with poor disease control and lower quality of life, thus imposing a substantial medical and economic burden worldwide. This review investigates the association between asthma and T2DM, in terms of pathogenesis, clinical outcomes, and therapeutic opportunities. Our review found an increased risk of asthma among diabetics, and vice versa. Having diabetes and poor glycemic control is associated with an increased rate of asthma exacerbations and increased mortality among those hospitalized for asthma exacerbations. The mechanisms postulated for the diabetes-asthma association include chronic low-grade inflammation, obesity, hyperinsulinemia, and possibly diabetic pneumopathy. Usage of metformin, which is the first-line drug for type 2 diabetes, was found to be associated with a decreased asthma occurrence, asthma exacerbations, and asthma-related hospitalizations. Glucagon-like peptide 1 receptor agonists were also found to be associated with a lower occurrence of asthma exacerbations. Thiazolidinediones are also associated with lower rates of asthma exacerbations, but their clinical efficacy for the same was suggested to be limited. This literature review supports a partly causative association between asthma and diabetes. This comorbidity leads to poor patient compliance, worse disease outcomes, and poor quality of life. Thus, further studies are warranted to explore the prognostic implications, therapeutic opportunities, and specific clinical practice algorithms for patients with concurrent asthma and type 2 diabetes mellitus.
2型糖尿病（T2DM）和哮喘是慢性病，在相当比例的人群中同时存在。它们的合并症与疾病控制不佳和生活质量较低相关，从而在全球范围内带来了巨大的医疗和经济负担。本综述从发病机制、临床结局和治疗机会方面研究哮喘与T2DM之间的关联。我们的综述发现糖尿病患者患哮喘的风险增加，反之亦然。患有糖尿病且血糖控制不佳与哮喘发作率增加以及因哮喘发作住院患者的死亡率增加相关。推测的糖尿病与哮喘关联的机制包括慢性低度炎症、肥胖、高胰岛素血症以及可能的糖尿病性肺病。发现作为2型糖尿病一线药物的二甲双胍的使用与哮喘发生率降低、哮喘发作减少以及与哮喘相关的住院治疗减少相关。还发现胰高血糖素样肽1受体激动剂与哮喘发作发生率较低相关。噻唑烷二酮类药物也与哮喘发作率较低相关，但提示其对此的临床疗效有限。这篇文献综述支持哮喘与糖尿病之间存在部分因果关联。这种合并症导致患者依从性差、疾病结局更差以及生活质量低下。因此，有必要进一步开展研究，以探索合并哮喘和2型糖尿病患者的预后意义、治疗机会以及特定的临床实践算法。
