Hyperglycemia and the Lung

  • R. J. Cusack
  • J. Ball
  • B. J. Philips
Conference paper


An estimated 150 million people worldwide have diabetes [1]. A further 200 million have glucose intolerance and 40% of these will become diabetic over 5–10 years. By 2010 it is expected there will be 220 million diabetics, the majority of who will have type II diabetes, an increase compounded by an increasing prevalence of obesity and sedentary habit. The potential morbidity and mortality has serious worldwide economic implications [2].


Obstructive Sleep Apnea Alveolar Macrophage Glucose Intolerance Autonomic Neuropathy Intensive Insulin Therapy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    Zimmet P, Alberti KG, Shaw J (2001) Global and societal implications of the diabetes epidemic. Nature 414: 782–787PubMedCrossRefGoogle Scholar
  2. 2.
    American Diabetes Association (1998) Economic consequences of diabetes mellitus in the US in 1997. Diabetes Care 21: 296–309CrossRefGoogle Scholar
  3. 3.
    DECODE Study Group on behalf of the European Diabetes Epidemiology Study Group (1998) Will new diagnostic criteria for diabetes mellitus change phenotype of patients with diabetes? Reanalysis of European epidemiological data. Br Med J 317: 371–375CrossRefGoogle Scholar
  4. 4.
    Balkau B, Bertrais S, Ducimetiere P, Eschwege E (1999) Is there a glycemic threshold for mortality risk? Diabetes Care 22: 696–699PubMedCrossRefGoogle Scholar
  5. 5.
    Ray NF, Thamer M, Taylor T, Fehrenbach SN, Ratner R (1996) Hospitalization and expenditures for the treatment of general medical conditions among the US diabetic population in 1991. J Clin Endocrinol Metab 81: 3671–3679PubMedCrossRefGoogle Scholar
  6. 6.
    van den Berghe G, Wouters P, Weekers F, et al (2001) Intensive insulin therapy in the critically ill patient. N Engl J Med 345: 1359–1367PubMedCrossRefGoogle Scholar
  7. 7.
    Umpierrez GE, Isaacs SD, Bazargan N, You X, Thaler LM, Kitabchi AE (2002) Hyperglycemia: an independent marker of in-hospital mortality in patients with undiagnosed diabetes. J Clin Endocrinol Metab 87: 978–982PubMedCrossRefGoogle Scholar
  8. 8.
    Johan Groeneveld AB, Beishuizen A, Visser FC (2002) Insulin: a wonder drug in the critically ill? Crit Care 6: 102–105CrossRefGoogle Scholar
  9. 9.
    Oursler KK, Moore RD, Bishai WR, Harrington SM, Pope DS, Chaisson RE (2002) Survival of patients with pulmonary tuberculosis: clinical and molecular epidemiologic factors. Clin Infect Dis 34: 752–759PubMedCrossRefGoogle Scholar
  10. 10.
    Lovering AM, MacGowan AP, Anderson P, Irwin D (2001) Epidemiology and resource utilization for patients hospitalized for lower respiratory tract infection. Clin Microbiol Infect 7: 666–670PubMedCrossRefGoogle Scholar
  11. 11.
    Zanobetti A, Schwartz J (2001) Are diabetics more susceptible to the health effects of airborne particles? Am J Respir Crit Care Med 164: 831–833PubMedCrossRefGoogle Scholar
  12. 12.
    Ulrich P, Cerami A (2001) Protein glycation, diabetes, and aging. Recent Prog Horm Res 56: 1–21PubMedCrossRefGoogle Scholar
  13. 13.
    Brownlee M (2001) Biochemistry and molecular cell biology of diabetic complications. Nature 414: 813–820PubMedCrossRefGoogle Scholar
  14. 14.
    Schmidt AM, Mora R, Cao R, et al (1994) The endothelial cell binding site for advanced glycation end products consists of a complex: an integral membrane protein and a lactoferrin-like polypeptide. J Biol Chem 269: 9882–9888PubMedGoogle Scholar
  15. 15.
    Soulis T, Thallas V, Youssef S, et al (1997) Advanced glycation end products and their receptors co-localise in rat organs susceptible to diabetic microvascular injury. Diabetologia 40: 619–628PubMedCrossRefGoogle Scholar
  16. 16.
    Lange P, Groth S, Kastrup J, et al (1989) Diabetes mellitus, plasma glucose and lung function in a cross-sectional population study. Eur Respir J 2: 14–19PubMedGoogle Scholar
  17. 17.
    Sandler M (1990) Is the lung a `target organ’ in diabetes mellitus? Arch Intern Med 150: 1385–1388PubMedCrossRefGoogle Scholar
  18. 18.
    Wanke T, Formanek D, Auinger M, Popp W, Zwick H, Irsigler K (1991) Inspiratory muscle performance and pulmonary function changes in insulin-dependent diabetes mellitus. Am Rev Respir Dis 143: 97–100PubMedCrossRefGoogle Scholar
  19. 19.
    Sandler M, Bunn AE, Stewart RI (1987) Cross-section study of pulmonary function in pa-Google Scholar
  20. tients with insulin-dependent diabetes mellitus. Am Rev Respir Dis 135:223–229Google Scholar
  21. 20.
    Ramirez LC, Dal Nogare A, Hsia C, et al (1991) Relationship between diabetes control andGoogle Scholar
  22. pulmonary function in insulin-dependent diabetes mellitus. Am J Med 91:371–376Google Scholar
  23. 21.
    Milla CE, Warwick WJ, Moran A (2000) Trends in pulmonary function in patients with cystic fibrosis correlate with the degree of glucose intolerance at baseline. Am J Respir Crit Care Med 162: 891–895PubMedCrossRefGoogle Scholar
  24. 22.
    Fuso L, Cotroneo P, Basso S, et al (1996) Postural variations of pulmonary diffusing capacity in insulin-dependent diabetes mellitus. Chest 110: 1009–1013PubMedCrossRefGoogle Scholar
  25. 23.
    Maccioni FJ, Colebatch HJ (1991) Lung volume and distensibility in insulin-dependent diabetes mellitus. Am Rev Respir Dis 143: 1253–1256PubMedCrossRefGoogle Scholar
  26. 24.
    Strojek K, Ziora D, Sroczynski JW, Oklek K (1992) Pulmonary complications of type 1 (insulin-dependent) diabetic patients. Diabetologia 35: 1173–1176PubMedCrossRefGoogle Scholar
  27. 25.
    Kida K, Utsuyama M, Takizawa T, Thurlbeck WM (1983) Changes in lung morphologic features and elasticity caused by streptozotocin-induced diabetes mellitus in growing rats. Am Rev Respir Dis 128: 125–131PubMedGoogle Scholar
  28. 26.
    Russ RD, Tobin BW (1996) Alteration of segmental vascular resistance in the pulmonary circulation of diabetic rats. Can J Physiol Pharmacol 74: 1010–1015PubMedCrossRefGoogle Scholar
  29. 27.
    Popov D, Simionescu M (1997) Alterations of lung structure in experimental diabetes, and diabetes associated with hyperlipidaemia in hamsters. Eur Respir J 10: 1850–1858PubMedCrossRefGoogle Scholar
  30. 28.
    Irizar A, Ioannides C (1995) Extrahepatic expression of P450 proteins in insulin-dependent diabetes mellitus. Xenobiotica 25: 941–949PubMedCrossRefGoogle Scholar
  31. 29.
    Myint H, Chacko J, Mould S, Ross F, Oscier DG (1995) Karyotypic evolution in a granulocytic sarcoma developing in a myeloproliferative disorder with a novel (3;4) translocation. Br J Haematol 90: 462–464PubMedCrossRefGoogle Scholar
  32. 30.
    Ofulue AF, Khadempour MH, Thurlbeck WM (1994) Diminished levels of insulin-like growth factor-I in lungs in streptozotocin-induced diabetes: relation to nutritional status and growth. Exp Lung Res 20: 27–40PubMedCrossRefGoogle Scholar
  33. 31.
    Weynand B, Jonckheere A, Frans A, Rahier J (1999) Diabetes mellitus induces a thickening of the pulmonary basal lamina. Respiration 66: 14–19PubMedCrossRefGoogle Scholar
  34. 32.
    Farina J, Furio V, Fernandez-Acenero MJ, Muzas MA (1995) Nodular fibrosis of the lung in diabetes mellitus. Virchows Arch 427: 61–63PubMedCrossRefGoogle Scholar
  35. 33.
    Ziegler D (1994) Diabetic cardiovascular autonomic neuropathy: prognosis, diagnosis and treatment. Diabetes Metab Rev 10: 339–383PubMedCrossRefGoogle Scholar
  36. 34.
    Sobotka PA, Liss HP, Vinik AI (1986) Impaired hypoxic ventilatory drive in diabetic patients with autonomic neuropathy. J Clin Endocrinol Metab 62: 658–663PubMedCrossRefGoogle Scholar
  37. 35.
    Scano G, Filippelli M, Romagnoli I, et al (2000) Hypoxic and hypercapnic breathlessness in patients with type I diabetes mellitus. Chest 117: 960–967PubMedCrossRefGoogle Scholar
  38. 36.
    Wanke T, Abrahamian H, Lahrmann H, et al (1993) No effect of naloxone on ventilatory response to progressive hypercapnia in IDDM patients. Diabetes 42: 282–287PubMedCrossRefGoogle Scholar
  39. 37.
    Nishimura M, Miyamoto K, Suzuki A, et al (1989) Ventilatory and heart rate responses to hypoxia and hypercapnia in patients with diabetes mellitus. Thorax 44: 251–257PubMedCrossRefGoogle Scholar
  40. 38.
    Tantucci C, Scionti L, Bottini P, et al (1997) Influence of autonomic neuropathy of different severities on the hypercapnic drive to breathing in diabetic patients. Chest 112: 145–153PubMedCrossRefGoogle Scholar
  41. 39.
    Ficker JH, Dertinger SH, Siegfried W, et al (1998) Obstructive sleep apnoea and diabetes mellitus: the role of cardiovascular autonomic neuropathy. Eur Respir J 11: 14–19PubMedCrossRefGoogle Scholar
  42. 40.
    Elmasry A, Lindberg E, Berne C, et al (2001) Sleep-disordered breathing and glucose metabolism in hypertensive men: a population-based study. J Intern Med 249: 153–161PubMedCrossRefGoogle Scholar
  43. 41.
    Waltenberger J, Lange J, Kranz A (2000) Vascular endothelial growth factor-A-induced chemotaxis of monocytes is attenuated in patients with diabetes mellitus: A potential predictor for the individual capacity to develop collaterals. Circulation 102: 185–190Google Scholar
  44. 42.
    Sima AA, O’Neill SJ, Naimark D, Yagihashi S, Klass D (1988) Bacterial phagocytosis and intracellular killing by alveolar macrophages in BB rats. Diabetes 37: 544–549PubMedCrossRefGoogle Scholar
  45. 43.
    Mohsenin V, Latifpour J (1990) Respiratory burst in alveolar macrophages of diabetic rats. J Appl Physiol 68: 2384–2390PubMedGoogle Scholar
  46. 44.
    Andersen B, Goldsmith GH, Spagnuolo PJ (1988) Neutrophil adhesive dysfunction in diabetes mellitus; the role of cellular and plasma factors. J Lab Clin Med 111: 275–285PubMedGoogle Scholar
  47. 45.
    Tennenberg SD, Finkenauer R, Dwivedi A (1999) Absence of lipopolysaccharide-induced inhibition of neutrophil apoptosis in patients with diabetes. Arch Surg 134:1229–1233; discussion 1233–1224Google Scholar
  48. 46.
    Moss M, Guidot DM, Steinberg KP, et al (2000) Diabetic patients have a decreased incidence of acute respiratory distress syndrome. Crit Care Med 28: 2187–2192PubMedCrossRefGoogle Scholar
  49. 47.
    von Kanel R, Mills PJ, Dimsdale JE (2001) Short-term hyperglycemia induces lymphopenia and lymphocyte subset redistribution. Life Sci 69: 255–262CrossRefGoogle Scholar
  50. 48.
    Rassias AJ, Givan AL, Marrin CA, Whalen K, Pahl J, Yeager MP (2002) Insulin increases neutrophil count and phagocytic capacity after cardiac surgery. Anesth Analg 94: 1113 1119Google Scholar
  51. 49.
    Hartshorn KL, Crouch E, White MR, et al (1998) Pulmonary surfactant proteins A and D enhance neutrophil uptake of bacteria. Am J Physiol 274: L958–969PubMedGoogle Scholar
  52. 50.
    Reading PC, Allison J, Crouch EC, Anders EM (1998) Increased susceptibility of diabetic mice to influenza virus infection: compromise of collectin-mediated host defense of the lung by glucose? J Virol 72: 6884–6887PubMedGoogle Scholar
  53. 51.
    Hennessey PJ, Black CT, Andrassy RJ (1991) Nonenzymatic glycosylation of immunoglobulin G impairs complement fixation. JPEN J Parenter Enteral Nutr 15: 60–64PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2003

Authors and Affiliations

  • R. J. Cusack
  • J. Ball
  • B. J. Philips

There are no affiliations available

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