Chronic obstructive pulmonary disease and diabetes: a look at the epidemiology, pathogenetic mechanisms, treatment

Abstract

Lately, increasingly studied the negative impact of diabetes type 2 on chronic obstructive pulmonary disease (COPD). According to literary data diabetes type 2 is more often diagnosed in patients with COPD in comparison with the general population: diabetes type 2 occur among patients with COPD in 18.7%, in comparison with patients without COPD – in 10,5%. The complexity of this association is primarily that chronic obstructive lung disease is regarded as a risk factor for diabetes type 2. The results of some researches show existence of close connection between the glycemic status and spirometric indicators – forced expiratory volume 1-second, forced vital capacity. Obstructive, restrictive, mixed ventilatory lung dysfunction observed in the states prior to the beginning of diabetes, such as impaired glucose tolerance and / or in patients with metabolic syndrome. The associations between lungs function and diabetes type 2 is explained by biochemical changes in airways, in lungs tissue. In patients with diabetes type 2 the decrease of lungs function is considered as a result of diabetes type 2 and as risk of development and progressing of COPD. Communication between the two complex nosologies – COPD and diabetes type 2 is confirmed by epidemiological data, common pathogenetic mechanisms – chronic systemic inflammation, oxidative stress, hypoxia, chronic hyperglycemia, side effects of drugs used in the treatment of two diseases – inhaled and / or systemic corticosteroids, inhaled bronchodilators, oral hypoglycemic agents. However, the pathogenetic mechanisms underlying the high prevalence of diabetes type 2 in patients with COPD is still unclear and requires a detailed study. Thus, it is actually and reasonable to conduct scientific and clinical work on identifying and better understanding of the exact mechanisms of the association between COPD and diabetes type 2 to develop methods for their correction, prevention and selection of adequate combination regimens in patients with these comorbid pathologies.