Impaired diffusing capacity for carbon monoxide in children with type 1 diabetes: is this the first sign of long-term complications?
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- Scaramuzza, A.E., Morelli, M., Rizzi, M. et al. Acta Diabetol (2012) 49: 159. doi:10.1007/s00592-011-0353-2
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We assessed the presence of lung dysfunction in children with type 1 diabetes, evaluated as reduced diffusing capacity of the lung for carbon monoxide (DLCO), and its components: membrane diffusing capacity (DM) and pulmonary capillary blood volume (Vc). A total of 42 children, aged 15.6 ± 3.8 years, with type 1 diabetes for 8.3 ± 5.5 years, and 30 healthy age and sex-matched peers were recruited for the study. Lung volumes and spirometric dynamic parameters were assessed by plethysmography. Single-breath DLCO was measured according to international recommendation. DM and Vc volume were calculated. Lung volumes were significantly reduced in young patients with type 1 diabetes when compared to controls. Moreover, DLCO was reduced in patients compared to controls (78% ± 16% vs. 120% ± 1%, P = 0.0001). However, when differentiating DM and Vc compartments, we observed a significant impairment only about Vc (34 ± 20 ml vs. 88 ± 18 ml; P = 0.0001), while no difference was observed about DM compartment (23 ± 4 vs. 26 ± 3 ml/min/mmHg, P = 0.798). Whether this might be seen as the “first” sign of microangiopathic involvement in patients with type 1 diabetes has to be confirmed on larger groups but is still fascinating. Meanwhile, we suggest to screen DLCO in all patients with type 1 diabetes.
KeywordsAdolescents Children Lung diffusion Lung function Microangiopathic complications Type 1 diabetes
Body mass index
Diffusing capacity of the lung for carbon monoxide
Membrane diffusing capacity
Forced expiratory volume in 1 s
Forced vital capacity
Carbon monoxide transfer coefficient
Total lung capacity
Pulmonary capillary blood volume