With Prevalence of Type 2 Diabetes and COPD Increasing Worldwide, Researchers Look for Links

With the prevalence of type 2 diabetes and chronic obstructive pulmonary disease (COPD) rising, a team of researchers is discussing the latest research linking both diseases, and the recommended therapeutic approaches for patients with coexisting COPD and diabetes.

The study “COPD and Type 2 Diabetes,” published in the journal Current Respiratory Medicine Reviews, was led by researchers at the endocrinology department of the Springfield Clinic in Illinois.

Patients with type 2 diabetes have high sugar levels in the blood (hyperglycemia) due to a failure of cells to respond properly to insulin — a condition called insulin resistance. (Insulin is the hormone that controls the body’s sugar levels.)

According to the team, in 2013 alone, 382 million people worldwide were diagnosed with type 2 diabetes; the disease is expected to affect 592 million people by 2035.

Risk factors for diabetes are well known, including obesity, lack of exercise, age, cholesterol levels, and high blood pressure. But there also is increasing evidence that links COPD to developing diabetes.

In COPD, patients experience a chronic obstruction of the airflow that leads to a high rate of mortality and morbidity.

According to the review, in 2010 about 11.7 percent of the global population had COPD (about 384 million cases). Researchers predict that by 2030 COPD will be the third leading cause of death globally.

Studies suggest that general inflammation typical of COPD could be responsible for the development of type 2 diabetes. Moreover, other complications derived from COPD could explain its association to diabetes such as obesity, shortage of oxygen (hypoxia), and the use of corticosteroids to reduce inflammation.

In turn, high sugar levels in blood also affect lung function, and potentially could increase the risk for developing COPD.

Current treatments for COPD and type 2 diabetes are focused mainly on symptom management, but fail to address the causes of the diseases.

The standard-of-care respiratory therapies in place for COPD include flu vaccination, antibiotics, and timely treatment of COPD exacerbations. Together, these approaches are expected to reduce general inflammation and oxidative stress (an imbalance between the body’s production of potentially harmful reactive oxygen species and its ability to contain them). These strategies are expected to also reduce insulin resistance and improve blood sugar levels in type 2 diabetes patients.

Patients with both COPD and type 2 diabetes are known to have worse outcomes than patients with diabetes alone. That is why it’s important to regulate sugar levels in order to avoid severe complications in this patient population.

Researchers emphasized that doctors should screen patients for COPD and type 2 diabetes together in order to improve patient care.

“Given the overwhelming evidence of the association between the COPD and T2 DM [type 2 diabetes], their intertwined pathologies and the impact on the prognosis, it is important for the endocrinologist to measure lung function in T2 DM patients, and for pulmonologists to screen for T2 DM in COPD patients,” the researchers wrote.

The team also stressed that more research is needed to better understand the link between COPD and type 2 diabetes.