title: The Influence of Type 1 Diabetes Mellitus on Pulmonary Function and Exercise Capacity - Results from the Study of Health in Pomerania (SHIP).
abstract: Background:Diabetes mellitus Type 1 (T1DM) is associated with metabolic and microvascular diseases as part of a multi-organ and multi-systemic disorder. The dense network of capillary vessels in the lungs may change during the course of the development of microangiopathy. The connective tissue as well as alveoli may be subjected to non-enzymatic glycosylation of proteins which may in turn affect pulmonary function. Previous studies investigating lung function in patients with type 1 diabetes have only been performed on small numbers of patients. Our study is based on population data of the Study of Health in Pomerania (SHIP).Objective:To investigate the influence of metabolic control on pulmonary system function and to establish a decreased pulmonary system function as a late complication of T1DM in a population based setting.Methods:The study is a case matched study with multiple controls based on participants with T1DM (SHIP-DM-1, n=73) and non-diabetics (SHIP-1, n=292) from the population based study of Pomerania. Data on lung function and exercise performance stratified by age, sex, body mass index and smoking habits in participants with T1DM and without diabetes were matched.Results:Participants with T1DM showed a significantly lower total lung capacity, residual volume and forced vital capacity. The transfer factor for carbon monoxide, the maximum power output and oxygen uptake during exercise were significantly decreased in comparison to the general population without diabetes.Conclusion:The pattern of abnormal pulmonary function as observed in the present study with a reduction in lung volume parameters and reduced oxygen uptake in participants with T1DM suggests a restrictive type of lung disease caused by an intrinsic lung tissue derangement as well as pulmonary microangiopathy.
authors.affiliation: Department of Internal Medicine B, Cardiology, Pneumology, Weaning, Infectious Diseases, Intensive Care Medicine, University Medicine Greifswald, Germany.
authors.forename: Beate
authors.initials: B
authors.lastname: Stubbe
authors.affiliation: Institute for Community Medicine, SHIP/Clinical-Epidemiological Research, University Medicine Greifswald, Germany.
authors.forename: Sabine
authors.initials: S
authors.lastname: Schipf
authors.affiliation: Department of Internal Medicine B, Cardiology, Pneumology, Weaning, Infectious Diseases, Intensive Care Medicine, University Medicine Greifswald, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Schäper
authors.affiliation: Department of Internal Medicine B, Cardiology, Pneumology, Weaning, Infectious Diseases, Intensive Care Medicine, University Medicine Greifswald, Germany.
authors.forename: Stephan B
authors.initials: SB
authors.lastname: Felix
authors.affiliation: Department of Internal Medicine A, University Medicine Greifswald, Germany.
authors.forename: Antje
authors.initials: A
authors.lastname: Steveling
authors.affiliation: Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Nauck
authors.affiliation: Institute for Community Medicine, SHIP/Clinical-Epidemiological Research, University Medicine Greifswald, Germany.
authors.forename: Henry
authors.initials: H
authors.lastname: Völzke
authors.affiliation: Medical Practice, Erfurt, Germany.
authors.forename: Henri
authors.initials: H
authors.lastname: Wallaschofski
authors.affiliation: Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Germany.
authors.forename: Nele
authors.initials: N
authors.lastname: Friedrich
authors.affiliation: Department of Internal Medicine B, Cardiology, Pneumology, Weaning, Infectious Diseases, Intensive Care Medicine, University Medicine Greifswald, Germany.
authors.forename: Ralf
authors.initials: R
authors.lastname: Ewert
authors.affiliation: Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Germany.
authors.forename: Till
authors.initials: T
authors.lastname: Ittermann
authors.affiliation: Department of Internal Medicine B, Cardiology, Pneumology, Weaning, Infectious Diseases, Intensive Care Medicine, University Medicine Greifswald, Germany.
authors.forename: Sven
authors.initials: S
authors.lastname: Gläser
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003922:Diabetes Mellitus, Type 1 / Q000503:physiopathology*; D015444:Exercise; D005260:Female; D005858:Germany; D006801:Humans; D008176:Lung Volume Measurements; D008297:Male; D008875:Middle Aged; D010807:Physical Endurance; D012123:Pulmonary Ventilation