title: Pulmonary function reduction in diabetes with and without chronic obstructive pulmonary disease.
abstract: OBJECTIVE
  Diabetes damages major organ systems through disrupted glycemic control and increased inflammation. The effects of diabetes on the lung have been of interest for decades, but the modest reduction in pulmonary function and its nonprogressive nature have limited its investigation. A recent systematic review found that diabetes was associated with reductions in forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), and diffusing capacity for carbon monoxide of the lung and increased FEV1/FVC. They reported pooled results including few smokers. This study will examine measures of pulmonary function in participants with extensive smoking exposure.
  
  
  METHODS
  We examined pulmonary function in participants with a >10-pack-year history of smoking with and without diabetes with and without chronic obstructive pulmonary disease (COPD). We measured pulmonary function, exercise capacity, and pulmonary-related quality of life in 10,129 participants in the Genetic Epidemiology of Chronic Obstructive Pulmonary Disease (COPDGene) Study.
  
  
  RESULTS
  Participants with diabetes were observed to have reduced pulmonary function after controlling for known risk factors and also significant reductions in exercise capacity and quality of life across functional stages of COPD.
  
  
  CONCLUSIONS
  Pulmonary function in patients with ≥10 pack-years of smoking and diabetes is reduced, and this decrease is associated with significant reductions in activity-related quality of life and exercise capacity.
authors.affiliation: Corresponding author: Gregory L. Kinney, greg.kinney@ucdenver.edu.
authors.forename: Gregory L
authors.initials: GL
authors.lastname: Kinney
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Black-Shinn
authors.forename: Emily S
authors.initials: ES
authors.lastname: Wan
authors.forename: Barry
authors.initials: B
authors.lastname: Make
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Regan
authors.forename: Sharon
authors.initials: S
authors.lastname: Lutz
authors.forename: Xavier
authors.initials: X
authors.lastname: Soler
authors.forename: Edwin K
authors.initials: EK
authors.lastname: Silverman
authors.forename: James
authors.initials: J
authors.lastname: Crapo
authors.forename: John E
authors.initials: JE
authors.lastname: Hokanson
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000503:physiopathology*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000503:physiopathology*; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000503:physiopathology*; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D014797:Vital Capacity
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