Research article summary (published 30 Aug 2009):

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

Full 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 (FEV(1))% from baseline (Delta FEV(1)) 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 13.5 +/- 7.7 years. The mean decrease of FEV(1) at pre-insulin assessment was 2.96 +/- 2.6%. Compared with the pre-insulin value, a significant increase of Delta FEV(1) 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 (Delta FEV(1), 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.

Author information

Author/s: Terzano, Claudio (C); Morano, Susanna (S); Ceccarelli, Daniela (D); Conti, Vittoria (V); Paone, Gregorino (G); Petroianni, Angelo (A); Graziani, Elda (E); Carnovale, Anna (A); Fallarino, Mara (M); Gatti, Alessandra (A); Mandosi, Elisabetta (E); Lenzi, Andrea (A);

Affiliation: Department of Cardiovascular and Respiratory Sciences, Respiratory Diseases Unit, Fondazione E. Lorillard Spencer Cenci, Sapienza University of Rome, Italy. cterzano(-atsign-)tin.it

Journal and publication information

Publication Type: Clinical Trial; Journal Article

Journal: The Journal of asthma : official journal of the Association for the Care of Asthma (J Asthma), published in England. (Language: eng)

Reference: 2009-Sep; vol 46 (issue 7) : pp 703-7

Dates: Created 2009/09/03; Completed 2009/09/28;

PMID: 19728209, status: MEDLINE (last retrieval date: 9/28/2009, IMS Date: )

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Aged Blood Glucose - drug effects; metabolism Bronchial Hyperreactivity - chemically induced; physiopathology Bronchial Provocation Tests Cohort Studies Diabetes Mellitus, Type 2 - blood; drug therapy Female

Forced Expiratory Volume - drug effects; physiology Hemoglobin A, Glycosylated - metabolism Humans Immunoglobulin E - blood Insulin - administration & dosage; pharmacology; therapeutic use Male Middle Aged

Associated Chemicals: Blood Glucose (0) ; Hemoglobin A, Glycosylated (0) ; hemoglobin A1c protein, human (0) ; Insulin (11061-68-0) ; Immunoglobulin E (37341-29-0)

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