About all

Asthma and diabetes. Exploring the Diabetes-Asthma Connection: Risk Factors, Management, and Latest Research

How are diabetes and asthma linked. What are the risk factors for both conditions. How can lifestyle choices impact diabetes and asthma management. What does current research reveal about the relationship between these chronic conditions.

The Intriguing Link Between Diabetes and Asthma

Recent scientific investigations have begun to uncover a fascinating connection between two seemingly unrelated chronic conditions: diabetes and asthma. While these diseases affect different bodily systems, emerging evidence suggests they may be more intertwined than previously thought. This article delves into the latest research, exploring potential links, shared risk factors, and management strategies for individuals dealing with both conditions.

Understanding Diabetes and Asthma

Before we explore their relationship, it’s crucial to understand the basics of each condition:

  • Diabetes: A metabolic disorder characterized by difficulties in maintaining optimal blood sugar levels
  • Asthma: A respiratory condition causing airway inflammation and narrowing, leading to breathing difficulties

While they may seem disparate, recent studies have uncovered intriguing connections between these chronic conditions.

The Bidirectional Risk: Asthma and Diabetes as Risk Factors for Each Other

Research has revealed a potential bidirectional relationship between asthma and diabetes. A 2020 study found that siblings of individuals with asthma had an increased risk of developing type 1 diabetes, and vice versa. Additionally, a 2021 review established an association between asthma and type 2 diabetes.

Why might this connection exist? While scientists are still unraveling the complexities, one popular theory points to systemic inflammation as a potential common denominator. This underlying inflammatory state could potentially increase the risk of both conditions.

Potential Mechanisms of Interaction

Several hypotheses attempt to explain how these conditions might influence each other:

  1. Diabetes contributing to asthma: Elevated blood sugar or insulin levels in the lungs of people with diabetes may contribute to the development or worsening of asthma.
  2. Asthma treatment affecting diabetes: Corticosteroids, a mainstay of asthma treatment, can potentially cause or exacerbate diabetes.

These interactions highlight the importance of a holistic approach to managing both conditions.

Risk Factors for Asthma: Beyond the Diabetes Connection

Understanding the risk factors for asthma is crucial for both prevention and management. According to the American Lung Association, several factors can increase an individual’s likelihood of developing asthma:

  • Family history of asthma
  • Exposure to air pollution, tobacco smoke, or work-related pollutants
  • Smoking
  • Allergies
  • Viral infections
  • Obesity

It’s important to note that having one or more risk factors doesn’t guarantee the development of asthma. However, awareness of these factors can help individuals take proactive steps to reduce their risk.

Unraveling the Risk Factors for Diabetes

Diabetes, like asthma, has its own set of risk factors. Understanding these can aid in prevention and early intervention strategies.

Type 1 Diabetes Risk Factors

According to the Centers for Disease Control and Prevention (CDC), risk factors for type 1 diabetes include:

  • Having a close relative with type 1 diabetes
  • Being a child, teenager, or young adult
  • Being white

Type 2 Diabetes Risk Factors

Type 2 diabetes has a broader range of known risk factors:

  • Family history of diabetes
  • Prediabetes
  • Overweight or obesity
  • Age 45 or older
  • Physical inactivity
  • History of gestational diabetes
  • Having given birth to an infant weighing over 9 pounds

Certain ethnic and racial groups also face an increased risk of developing type 2 diabetes, including African Americans, Hispanic and Latino individuals, American Indians, Alaska Natives, and potentially Pacific Islanders and Asian Americans.

The Impact of Asthma Medications on Diabetes Management

For individuals managing both asthma and diabetes, treatment considerations become more complex. Some scientists have raised concerns about the potential impact of asthma medications on diabetes management.

A 2021 review found evidence that corticosteroids, a crucial component of asthma treatment, can increase blood sugar levels and potentially disrupt the body’s blood sugar control mechanisms. This presents a challenge for individuals dealing with both conditions, as corticosteroids play a vital role in managing asthma symptoms.

However, the relationship between asthma medications and diabetes is not entirely clear-cut. A 2020 study suggested that asthma only significantly affects diabetes when the asthma is severe. According to this research, inhaled steroids at low or mild doses do not substantially impact blood sugar levels.

These conflicting findings underscore the need for further research into optimal treatment strategies for individuals managing both diabetes and asthma. In the meantime, close monitoring and personalized treatment plans are crucial for these patients.

Lifestyle Strategies for Managing Diabetes and Asthma

While medical treatments play a crucial role in managing both diabetes and asthma, lifestyle choices can significantly impact the course of these conditions. Interestingly, many of the lifestyle recommendations for diabetes management can also benefit individuals with asthma.

CDC Recommendations for Diabetes Management

The CDC outlines several lifestyle choices that can help manage diabetes:

  • Maintaining a moderate body weight
  • Eating a nutritious diet
  • Getting regular exercise

NIH Insights on Asthma Management

According to the National Institutes of Health (NIH), these same measures can positively affect asthma management. This overlap in lifestyle recommendations highlights the potential benefits of a holistic approach to managing both conditions.

The Impact of Obesity on Diabetes and Asthma

Obesity emerges as a significant factor in both diabetes and asthma. Excess weight can exacerbate both conditions, making weight management a crucial component of treatment strategies. By maintaining a moderate body weight, individuals may be able to better control both their diabetes and asthma symptoms.

Current Research and Future Directions

As our understanding of the relationship between diabetes and asthma continues to evolve, researchers are exploring various aspects of this connection:

  • Systemic inflammation: Investigating the role of widespread inflammation in both conditions
  • Genetic factors: Exploring potential shared genetic risk factors
  • Treatment interactions: Studying how treatments for one condition might impact the other
  • Lifestyle interventions: Assessing the effectiveness of lifestyle changes in managing both conditions simultaneously

Future research directions may include:

  1. Long-term studies tracking the development and progression of both conditions in large populations
  2. Clinical trials evaluating treatment strategies for individuals with both diabetes and asthma
  3. Investigation into potential biomarkers that could predict the risk of developing both conditions
  4. Exploration of novel therapeutic approaches that could address both diabetes and asthma simultaneously

Navigating the Challenges of Dual Diagnosis

For individuals diagnosed with both diabetes and asthma, managing these conditions simultaneously can present unique challenges. Here are some strategies to consider:

  • Open communication with healthcare providers: Ensure all your doctors are aware of both conditions and the treatments you’re receiving
  • Regular monitoring: Keep track of both blood sugar levels and lung function
  • Medication management: Work with your healthcare team to find the optimal balance of medications for both conditions
  • Lifestyle focus: Embrace healthy eating, regular exercise, and stress management techniques
  • Education: Stay informed about both conditions and how they might interact

By taking a proactive approach to managing both diabetes and asthma, individuals can work towards better overall health and quality of life.

The Role of Personalized Medicine

As our understanding of the diabetes-asthma connection grows, the importance of personalized medicine becomes increasingly apparent. Each individual’s experience with these conditions is unique, and treatment strategies should reflect this diversity. Healthcare providers may consider factors such as:

  • Genetic predisposition
  • Environmental factors
  • Lifestyle habits
  • Severity of each condition
  • Individual response to various treatments

This personalized approach can help optimize treatment outcomes and minimize potential complications arising from the interaction between diabetes and asthma.

The Importance of Ongoing Research and Awareness

As we continue to uncover the complexities of the diabetes-asthma connection, ongoing research and increased awareness are crucial. These efforts can lead to:

  • Improved diagnostic tools for early detection of both conditions
  • More effective treatment strategies that address the unique needs of individuals with both diabetes and asthma
  • Enhanced understanding of the underlying mechanisms linking these conditions
  • Development of preventive strategies to reduce the risk of developing both diabetes and asthma

By staying informed about the latest research and developments, both healthcare providers and patients can make more informed decisions about management and treatment strategies.

The Role of Patient Advocacy

Individuals living with both diabetes and asthma can play a crucial role in advancing our understanding of these conditions. Patient advocacy can take many forms:

  • Participating in clinical trials
  • Sharing personal experiences with healthcare providers and researchers
  • Raising awareness about the challenges of managing both conditions
  • Supporting organizations dedicated to diabetes and asthma research

Through these efforts, patients can contribute to the ongoing quest for better treatments and management strategies for both diabetes and asthma.

Embracing a Holistic Approach to Health

The emerging understanding of the diabetes-asthma connection underscores the importance of viewing health from a holistic perspective. Rather than treating these conditions in isolation, a comprehensive approach that considers the interplay between various bodily systems may lead to better outcomes.

This holistic view extends beyond just diabetes and asthma. It encourages us to consider how different aspects of health – including diet, exercise, stress management, and environmental factors – all contribute to overall well-being. By embracing this broader perspective, individuals can take proactive steps to improve their health across multiple dimensions.

The Power of Preventive Care

As we learn more about the risk factors and potential connections between diabetes and asthma, the value of preventive care becomes increasingly apparent. Preventive strategies may include:

  • Regular health check-ups and screenings
  • Early intervention for prediabetes or mild asthma symptoms
  • Lifestyle modifications to reduce risk factors
  • Environmental interventions to reduce exposure to asthma triggers

By focusing on prevention, we may be able to reduce the incidence and severity of both diabetes and asthma, improving quality of life for countless individuals.

Conclusion and Future Outlook

The relationship between diabetes and asthma represents a fascinating area of ongoing research. As we continue to uncover the links between these conditions, new opportunities for prevention, diagnosis, and treatment emerge. While challenges remain in managing these complex chronic conditions, the growing body of knowledge offers hope for improved outcomes.

For individuals living with both diabetes and asthma, staying informed, working closely with healthcare providers, and embracing a holistic approach to health can make a significant difference. As research progresses, we can look forward to more targeted, effective strategies for managing these interrelated conditions, ultimately leading to better health and quality of life for those affected.

The journey to fully understanding the diabetes-asthma connection is ongoing, but each new discovery brings us closer to more effective, personalized approaches to care. By continuing to invest in research, raise awareness, and empower patients, we can work towards a future where both diabetes and asthma are more easily prevented, managed, and potentially even cured.

Diabetes and asthma: Is there a link?

There is some evidence that diabetes is a risk factor for asthma and vice versa. Some experts suggest that systemic inflammation could play a role in both conditions. Asthma medications may contribute to diabetes, and diabetes may cause changes in the lungs that contribute to asthma.

Asthma is a condition that affects a person’s airways, causing them to close and become inflamed. In diabetes, the body has difficulties maintaining optimal blood sugar levels, causing them to become too high. Although they are both chronic conditions, many people initially assume there is no link between asthma and diabetes.

However, scientists have begun to explore possible links between asthma and diabetes. This article explains the latest research, risk factors, and management strategies for both conditions.

There are two types of diabetes. Type 1 diabetes is an autoimmune condition where the immune system destroys insulin-creating cells. In type 2 diabetes, the body does not produce sufficient insulin or does not react properly to the substance.

Asthma and diabetes may be risk factors for one another. A 2020 study found that siblings of people with asthma had an increased risk of type 1 diabetes and vice versa. Additionally, a 2021 review found an association between asthma and type 2 diabetes.

Scientists are unsure what causes this link. One popular theory suggests systemic inflammation could increase the risk of both conditions. However, diabetes could contribute to asthma, and asthma could contribute to diabetes.

For instance, some researchers suspect that asthma can develop or worsen because of elevated blood sugar or blood-insulin levels in the lungs of people with diabetes. Conversely, steroids are a mainstay of asthma treatment, though they can cause or exacerbate diabetes.

Learn more about diabetes.

According to the American Lung Association, there are several risk factors for asthma. These include:

  • a family history of asthma
  • exposure to air pollution, tobacco smoke, or work-related pollutants
  • smoking
  • allergies
  • viral infections
  • obesity

That said, having risk factors for a condition does not guarantee it will develop.

Learn more about asthma.

According to the Centers for Disease Control and Prevention (CDC), risk factors for type 1 diabetes include:

  • having a close relative with type 1 diabetes
  • being a child, teenager, or young adult
  • being white

There are many more known risk factors for type 2 diabetes. These include:

  • having a close relative with type 1 diabetes
  • having prediabetes
  • being overweight or obese
  • being 45 years of age or older
  • being physically active no more than twice per week
  • having a history of gestational diabetes
  • having given birth to an infant who weighed more than 9 pounds

Race and ethnicity are also relevant to type 2 diabetes. The following groups are at an increased risk of developing this condition:

  • African Americans
  • Hispanic and Latino individuals
  • American Indians
  • Alaska Natives

Scientists also suspect that being a Pacific Islander or an Asian American could also be a risk factor for type 2 diabetes.

Learn more about diabetes risk factors.

Some scientists have concerns that asthma medications could worsen a person’s diabetes.

However, the data on this connection remains unclear.

The 2021 review found evidence that corticosteroids can increase blood sugar levels. They may also disrupt the body’s control over blood sugar levels. Since corticosteroids are crucial for managing asthma, this could complicate treatment for people with both conditions.

On the other hand, a 2020 study found that asthma only affects diabetes when it is severe. The study argues that inhaled steroids do not affect blood sugar levels at low or mild doses. With this in mind, more research into treatment for people with diabetes and asthma is necessary.

The CDC outlines some lifestyle choices that can help with diabetes. Some of these choices could also benefit people with asthma. Individuals can manage diabetes by:

  • maintaining a moderate body weight
  • eating a nutritious diet
  • getting regular exercise

According to the National Institutes of Health (NIH), these measures can positively affect asthma.

Learn about the consequences of a sedentary lifestyle.

Some studies suggest that asthma could increase the risk of type 1 and 2 diabetes and vice versa. This link could be due to systemic inflammation, which may be at the root of both conditions.

Appropriate lifestyle choices help individuals manage both conditions. For instance, obesity may worsen asthma and diabetes, so people may benefit from maintaining a moderate body weight.

Having both diabetes and asthma could cause some challenges. Inhaled corticosteroids are crucial for managing asthma, yet some experts believe they may worsen a person’s diabetes.

Association between Asthma and Type 2 Diabetes Mellitus: Mechanisms and Impact on Asthma Control—A Literature Review

1. Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention. Fontana-on-Geneva Lake, WI, USA: Global Initiative for Asthma; 2018. https://ginasthma.org/wp-content/uploads/2019/01/2018-GINA.pdf. [Google Scholar]

2. Shu C. J., Benoist C., Mathis D. The immune system’s involvement in obesity-driven type 2 diabetes. Seminars in Immunology. 2012;24(6):436–442. doi: 10.1016/j.smim.2012.12.001. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

3. Perez M. K., Piedimonte G. Metabolic asthma: is there a link between obesity, diabetes and asthma? Immunology and Allergy Clinics of North America. 2014;34(4):777–784. doi: 10.1016/j.iac.2014.07.002. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

4. Salles C., Terse-Ramos R., Souza-Machado A., Cruz A. A. Obstructive sleep apnea and asthma. Jornal Brasileiro de Pneumologia. 2013;39(5):604–612. doi: 10.1590/s1806-37132013000500011. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

5. Zammit C., Liddicoat H., Moonsie I., Makker H. Obesity and respiratory diseases. International Journal of General Medicine. 2010;3:335–343. doi: 10.2147/IJGM.S11926. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

6. Su X., Ren Y., Li M., Zhao X., Kong L., Kang J. Prevalence of comorbidities in asthma and nonasthma patients. Medicine. 2016;95(22):p. e3459. doi: 10.1097/md.0000000000003459. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

7. Adeyeye O. O., Ogbera A. O., Ogunleye O. O., et al. Understanding asthma and the metabolic syndrome—a Nigerian report. International Archives of Medicine. 2012;5(1):p. 20. doi: 10.1186/1755-7682-5-20. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

8. Global Asthma Network. The Global Asthma Report 2018. Auckland, New Zealand: Global Asthma Network; 2018. http://www.globalasthmanetwork.org/publications/Global_Asthma_Report_2014.pdf. [Google Scholar]

9. International Diabetes Federation. IDF Diabetes Atlas. 9a. Brussels, Belgium: International Diabetes Federation; 2020. https://www.diabetesatlas.org/upload/resources/2019/IDF_Atlas_9th_Edition_2019.pdf. [Google Scholar]

10. World Health Organization. WHO. Obesity and Overweight. Fact Sheets N° 311. Geneva, Switzerland: World Health Organization; 2016. http://http://www.who.int/mediacentre/factsheets/fs311/en/l. [Google Scholar]

11. http://www.brasil.gov.br/saude/2015/01/asma-atinge-6-4-milhoes-de-brasileiros. Brasil. Ministério da Saúde. Portal da Saúde. Brasília: Ministério de Saúde. Asma atinge 6,4 milhões de brasileiros, 2019,

12. Brasil. Ministério da Saúde. Vigitel Brasil 2018—Vigilância de fatores de risco e proteção para doenças crônicas por inquérito telefônico: estimativas sobre frequência e distribuição sociodemográfica de fatores de risco e proteção para doenças crônicas nas capitais dos 26 estados brasileiros e no Distrito Federal em 2018—Brasília: DF, 2019.

13. Papi A., Brightling C., Pedersen S. E., Reddel H. K. Asthma. The Lancet. 2018;391(10122):783–800. doi: 10.1016/s0140-6736(17)33311-1. [PubMed] [CrossRef] [Google Scholar]

14. Mueller N. T., Koh W.-P., Odegaard A. O., Gross M. D., Yuan J.-M., Pereira M. A. Asthma and the risk of type 2 diabetes in the Singapore Chinese Health Study. Diabetes Research and Clinical Practice. 2013;99(2):192–199. doi: 10.1016/j.diabres.2012.11.019. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

15. Song Y., Klevak A., Manson J. E., Buring J. E., Liu S. Asthma, chronic obstructive pulmonary disease, and type 2 diabetes in the Women’s Health Study. Diabetes Research and Clinical Practice. 2010;90(3):365–371. doi: 10.1016/j.diabres.2010.09.010. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

16. Baek J. Y., Lee S. E., Han K., Koh E. H. Association between diabetes and asthma. Annals of Allergy, Asthma & Immunology. 2018;121(6):699–703. doi: 10.1016/j.anai.2018.08.008. [PubMed] [CrossRef] [Google Scholar]

17. Rana J. S., Mittleman M. A., Sheikh J., et al. Chronic obstructive pulmonary disease, asthma, and risk of type 2 diabetes in women. Diabetes Care. 2004;27(10):2478–2484. doi: 10.2337/diacare.27.10.2478. [PubMed] [CrossRef] [Google Scholar]

18. Gershon A. S., Guan J., Wang C., Victo, Charles J. To T. Describing and quantifying asthma comorbidty: a population study. PLoS One. 2012;7 doi: 10.1371/journal.pone.0034967.e34967 [PMC free article] [PubMed] [CrossRef] [Google Scholar]

19. Yun H. D., Knoebel E., Fenta Y., et al. Asthma and proinflammatory conditions: a population-based retrospective matched cohort study. Mayo Clinic Proceedings. 2012;87(10):953–960. doi: 10.1016/j.mayocp.2012.05.020. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

20. Wytrychowski K., Obojski A., Hans-Wytrychowska A. The influence of insulin therapy on the course of acute exacerbation of bronchial asthma. Advances in Experimental Medicine and Biology. 2016;884:45–51. doi: 10.1007/5584_2015_175. [PubMed] [CrossRef] [Google Scholar]

21. Klein O. L., Aviles-Santa L., Cai J., et al. Hispanics/latinos with type 2 diabetes have functional and symptomatic pulmonary impairment mirroring kidney microangiopathy: findings from the hispanic community health study/study of Latinos (HCHS/SOL) Diabetes Care. 2016;39(11):2051–2057. doi: 10.2337/dc16-1170. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

22. Tesse R., Schieck M., Kabesch M. Asthma and endocrine disorders: shared mechanisms and genetic pleiotropy. Molecular and Cellular Endocrinology. 2011;333(2):103–111. doi: 10.1016/j.mce.2010.11.032. [PubMed] [CrossRef] [Google Scholar]

23. Sweeney J., Patterson C. C., Menzies-Gow A., et al. Comorbidity in severe asthma requiring systemic corticosteroid therapy: cross-sectional data from the optimum patient care research database and the British thoracic difficult asthma registry. Thorax. 2016;71(4):339–346. doi: 10.1136/thoraxjnl-2015-207630. [PubMed] [CrossRef] [Google Scholar]

24. Rafacho A., Ortsäter H., Nadal A., Quesada I. Glucocorticoid treatment and endocrine pancreas function: implications for glucose homeostasis, insulin resistance and diabetes. Journal of Endocrinology. 2014;223(3):R49–R62. doi: 10.1530/joe-14-0373. [PubMed] [CrossRef] [Google Scholar]

25. Ernst P., Suissa S. Systemic effects of inhaled corticosteroids. Current Opinion in Pulmonary Medicine. 2011;18:85–89. [PubMed] [Google Scholar]

26. Moher D., Liberati A., Tetzlaff J., Altman D. G., The PRISMA Group Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Medicine. 2009;6(7) doi: 10.1371/journal.pmed.1000097.e100009 [PMC free article] [PubMed] [CrossRef] [Google Scholar]

27. Rodbard H. W., Bays H. E., Gavin J. R., et al. Rate and risk predictors for development of self-reported type-2 diabetes mellitus over a 5-year period: the SHIELD study. International Journal of Clinical Practice. 2012;66(7):684–691. doi: 10.1111/j.1742-1241.2012.02952.x. [PubMed] [CrossRef] [Google Scholar]

28. Thomsen S. F., Duffy D. L., Kyvik K. O., Skytthe A., Backer V. Risk of asthma in adult twins with type 2 diabetes and increased body mass index. Allergy. 2011;66(4):562–568. doi: 10.1111/j.1398-9995.2010.02504.x. [PubMed] [CrossRef] [Google Scholar]

29. Hashemzadeh M., Movahed M. R. The occurrence of asthma in hospitalized patients with type 2 diabetes mellitus. Internal Medicine Journal. 2009;39(10):699–701. doi: 10.1111/j.1445-5994.2009.01976.x. [PubMed] [CrossRef] [Google Scholar]

30. Gulcan E., Bulut I., Toker A., Gulcan A. Evaluation of glucose tolerance status in patients with asthma bronchiale. Journal of Asthma. 2009;46(2):207–209. doi: 10.1080/02770900802627302. [PubMed] [CrossRef] [Google Scholar]

31. Verbovoy A. F., Kosareva O. V., Akhmerova R. I. Leptin, resistin, and hormonal and metabolic parameters in women with type 2 diabetes and in those with its concurrence with asthma. Terapevticheskii Arkhiv. 2014;87:37–41. [PubMed] [Google Scholar]

32. Koskela H. O., Salonen P. H., Niskanen L. Hyperglycaemia during exacerbations of asthma and chronic obstructive pulmonary disease. The Clinical Respiratory Journal. 2013;7(4):382–389. doi: 10.1111/crj.12020. [PubMed] [CrossRef] [Google Scholar]

33. Suissa S., Kezouh A., Ernst P. Inhaled corticosteroids and the risks of diabetes onset and progression. The American Journal of Medicine. 2010;123(11):1001–1006. doi: 10.1016/j.amjmed.2010.06.019. [PubMed] [CrossRef] [Google Scholar]

34. Faul J. L., Wilson S. R., Chu J. W., Canfield J., Kuschner W. G. The effect of an inhaled corticosteroid on glucose control in type 2 diabetes. Clinical Medicine & Research. 2009;7(1-2):14–20. doi: 10.3121/cmr.2009.824. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

35. Kankaanranta H., Kauppi P., Tuomist L. E., Ilmarinen P. Emerging comorbidities in adult asthma: risks, clinical associations, and mechanisms. Mediators of Inflammation. 2016;2016:23. doi: 10.1155/2016/3690628.3690628 [PMC free article] [PubMed] [CrossRef] [Google Scholar]

36. Singh S., Prakash Y. S., Linneberg A., Agrawal A. Insulin and the lung: connecting asthma na metabolic syndrome. Journal of Allergy. 2013;1(20):37.627384 [Google Scholar]

37. Yeryomenko G. V., Bezditko T. V. The treatment of patients with asthma and comorbidity. Medicni Perspektivi (Medical Perspectives) 2018;23(1(part 1)):50–59. doi: 10.26641/2307-0404.2018.1(part1).127209. [CrossRef] [Google Scholar]

38. Li C.-Y., Erickson S. R., Wu C.-H. Metformin use and asthma outcomes among patients with concurrent asthma and diabetes. Respirology. 2016;21(7):1210–1218. doi: 10.1111/resp.12818. [PubMed] [CrossRef] [Google Scholar]

39. Koskela H. O., Salonen P. H., Romppanen J., Niskanen L. A history of diabetes but not hyperglycaemia during exacerbation of obstructive lung disease has impact on long-term mortality: a prospective, observational cohort study. BMJ Open. 2015;29(5)e006794 [PMC free article] [PubMed] [Google Scholar]

40. Wouters E. F. M., Reynaert N. L., Dentener M. A., Vernooy J. H. J. Systemic and local inflammation in asthma and chronic obstructive pulmonary disease: is there a connection? Proceedings of the American Thoracic Society. 2009;6(8):638–647. doi: 10.1513/pats.200907-073dp. [PubMed] [CrossRef] [Google Scholar]

41. Wellen K. E., Hotamisligil G. S., Hotamisligil G. S. Inflammation, stress, and diabetes. Journal of Clinical Investigation. 2005;115(5):1111–1119. doi: 10.1172/jci25102. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

42. Lee C. C., Liu S. Role of inflammatory cytokines in type 2 diabetes. Journal of Periodontology. 2008;79:1527–1534. [PubMed] [Google Scholar]

43. Berg A. H., Scherer P. E. Adipose tissue, inflammation, and cardiovascular disease. Circulation Research. 2005;96(9):939–949. doi: 10.1161/01.res.0000163635.62927.34. [PubMed] [CrossRef] [Google Scholar]

44. Bastard J. P., Maachi M., Lagathu C., et al. Recent advances in the relationship between obesity, inflammation, and insulin resistance. European Cytokine Network. 2006;17(1):4–12. [PubMed] [Google Scholar]

45. Chesné J., Braza F., Mahay G., Brouard S., Aronica M., Magnan A. IL-17 in severe asthma. Where do we stand? American Journal of Respiratory and Critical Care Medicine. 2014;190(10):1094–1101. doi: 10.1164/rccm.201405-0859pp. [PubMed] [CrossRef] [Google Scholar]

46. Ramalho R., Guimarães C. Papel do tecido adiposo e dos macrófagos no estado de inflamação crónica associada à obesidade: implicações Clínicas. Acta medica portuguesa. 2008;21:489–496. [PubMed] [Google Scholar]

47. Singh S., Bodas M., Bhatraju N. K., et al. Hyperinsulinemia adversely affects lung structure and function. American Journal of Physiology-Lung Cellular and Molecular Physiology. 2016;310(9):L837–L845. doi: 10. 1152/ajplung.00091.2015. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

48. Thuesen B. H., Husemoen L. L. N., Hersoug L.-G., Pisinger C., Linneberg A. Insulin resistance as a predictor of incident asthma-like symptoms in adults. Clinical & Experimental Allergy. 2009;39(5):700–707. doi: 10.1111/j.1365-2222.2008.03197.x. [PubMed] [CrossRef] [Google Scholar]

49. Agrawal A., Prakash Y. S. Obesity, metabolic syndrome, and airway disease. Immunology and Allergy Clinics of North America. 2014;34(4):785–796. doi: 10.1016/j.iac.2014.07.004. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

50. Lugogo N. L., Bappanad D., Kraft M. Obesity, metabolic dysregulation and oxidative stress in asthma. Biochimica et Biophysica Acta (BBA)—General Subjects. 2011;1810(11):1120–1126. doi: 10.1016/j.bbagen.2011.09.004. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

51. Brumpton B. M., Camargo C. A., Romundstad P. R., Langhammer A., Chen Y. , Mai X.-M. Metabolic syndrome and incidence of asthma in adults: the HUNT study. European Respiratory Journal. 2013;42(6):1495–1502. doi: 10.1183/09031936.00046013. [PubMed] [CrossRef] [Google Scholar]

52. Cottrell L., Neal W. A., Ice C., Perez M. K., Piedimonte G. Metabolic abnormalities in children with asthma. American Journal of Respiratory and Critical Care Medicine. 2011;183(4):441–448. doi: 10.1164/rccm.201004-0603oc. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

53. Klein O. L., Krishnan J. A., Glick S., Smith L. J. Systematic review of the association between lung function and Type 2 diabetes mellitus. Diabetic Medicine. 2010;27(9):977–987. doi: 10.1111/j.1464-5491.2010.03073.x. [PubMed] [CrossRef] [Google Scholar]

54. Aronson D. Hyperglycemia and the pathobiology of diabetic complications. Advances in Cardiology. 2008;45:1–16. doi: 10.1159/000115118. [PubMed] [CrossRef] [Google Scholar]

55. Yu D., Simmons D. Association between lung capacity measurements and abnormal glucose metabolism: findings from the Crossroads study. Diabetic Medicine. 2014;31(5):595–599. doi: 10.1111/dme.12346. [PubMed] [CrossRef] [Google Scholar]

56. O’Byrne P. M., Rennard S., Gerstein H., Radner F., Peterson S., Lindberg B. Risk of new onset diabetes mellitus in patients with asthma or COPD taking inhaled corticosteroids. Respiratory Medicine. 2012;106:1487–1493. [PubMed] [Google Scholar]

57. Katsuyama T., Sada K.-E., Namba S., et al. Risk factors for the development of glucocorticoid-induced diabetes mellitus. Diabetes Research and Clinical Practice. 2015;108(2):273–279. doi: 10.1016/j.diabres.2015.02.010. [PubMed] [CrossRef] [Google Scholar]

58. Van Raalte D. H., Ouwens D. M., Diamant M. Novel insights into glucocorticoid-mediated diabetogenic effects: towards expansion of therapeutic options? European Journal of Clinical Investigation. 2009;39(2):81–93. doi: 10.1111/j.1365-2362.2008.02067.x. [PubMed] [CrossRef] [Google Scholar]

59. Slatore C. G., Bryson C. L., Au D. H. The association of inhaled corticosteroid use with serum glucose concentration in a large cohort. The American Journal of Medicine. 2009;122(5):472–478. doi: 10.1016/j.amjmed.2008.09.048. [PubMed] [CrossRef] [Google Scholar]

60. Regateiro F., Moura A. L., Faria E. Novos biológicos para o tratamento da asma. Revista Portuguesa de Imunoalergologia. 2017;25:99–113. [Google Scholar]

61. Yalcin A. D., Gorczynski R. M., Cilli A., Strauss L. Omalizumab (anti-IgE) therapy increases blood glucose levels in severe persisten tallergic asthma patients with diabetes mellitus: 18-month follow-up. Clinical Laboratory. 2014;60:1561–1564. doi: 10.7754/clin.lab.2013.130302. [PubMed] [CrossRef] [Google Scholar]

62. Hamada S., Kuroe A., Tsukino M. Does omalizumab impair glucose homeostasis in a patient with severe persistent asthma and type 2 diabetes mellitus? Revista Portuguesa de Pneumologia (English Edition) 2017;23(5):303–304. doi: 10.1016/j.rppnen.2017.05.002. [PubMed] [CrossRef] [Google Scholar]

63. Ferreira L., Moniz A. C., Carneiro A. S., et al. The impact of glycemic variability on length of stay and mortality in diabetic patients admitted with community-acquired pneumonia or chronic obstructive pulmonary disease. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2019;13(1):149–153. doi: 10.1016/j.dsx.2018.08.028. [PubMed] [CrossRef] [Google Scholar]

64. Xia C., Rao X., Zhong J. Role of T Lymphocytes in type 2 diabetes and diabetes-associated inflammation. Journal of Diabetes Research. 2017;2017:6. doi: 10.1155/2017/6494795.6494795 [PMC free article] [PubMed] [CrossRef] [Google Scholar]

65. Black M. H., Anderson A., Bell R. A., et al. Prevalence of asthma and its association with glycemic control among youth with diabetes. Pediatrics. 2011;128(4):e839–e847. doi: 10.1542/peds.2010-3636. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

66. Rogliani P., Calzetta L., Capuani B., et al. Glucagon-like peptide 1 receptor: a novel pharmacological target for treating human bronchial hyperresponsiveness. American Journal of Respiratory Cell and Molecular Biology. 2016;55(6):804–814. doi: 10.1165/rcmb.2015-0311oc. [PubMed] [CrossRef] [Google Scholar]

67. Mitchell P. D., Salter B. M., Oliveria J. P., et al. Glucagon-like peptide-1 receptor expression on human eosinophils and its regulation of eosinophil activation. Clinical & Experimental Allergy. 2017;47(3):331–338. doi: 10.1111/cea.12860. [PubMed] [CrossRef] [Google Scholar]

68. Barros L. L., Souza-Machado A., Corrêa L. B., et al. Obesity and poor asthma control in patients with severe asthma. Journal of Asthma. 2011;48(2):171–176. doi: 10.3109/02770903.2011.554940. [PubMed] [CrossRef] [Google Scholar]

69. Forno E., Zhang P., Nouraie M., Courcoulas A., Mitchell J. E., Wolfe B. The impact of bariatric surgery on asthma control differs among obese individuals with reported prior or current asthma, with or without metabolic syndrome. PLoS One. 2019;14(4) doi: 10.1371/journal.pone.0214730.e0214730 [PMC free article] [PubMed] [CrossRef] [Google Scholar]

The combination of bronchial asthma and diabetes: synergism or antagonism? | Ivanov

1. Lowder T.W., Kunz H.E. Regulatory T cells in asthma and airway hyperresponsiveness. J. Allergy Ther. 2011; Suppl. 1:1–8.

2. Karlstad O., Nafstad P., Tverdal A. et al. Comorbidities in an asthma population 8–29 years old: a study from the Norwegian Prescription Database. Pharmacoepidemiol. drug. Saf. 2012; 21:1045–1052.

3. Shi H.N., Walker W.A. T helper cell subclasses and clinical disease states. Curr. Opin. Gastroenterol. 2002; 18:711–716.

4. Mineev V.N. The concept of bronchial asthma as a membrane-receptor pathology. Immunopathology, allergology, infectology. 2005; 3:68–85. / Mineev V.N. An approach to bronchial asthma as to membrane and receptor pathology. Immunopathology, allergology, infektologiya. 2005; 3: 68–85 (in Russian).

5. Vianna E.O., Garcia-Leme J. Allergen-induced airway inflammation in rats. Role of insulin. Am. J. Respir. Crit. care. Med. 1995; 151:809–814.

6. Insuela D.B.R., Silva P.M.R., Martins M.A., Carvalho V.F. The Yin Yang of hormones that control glucose homeostasis in asthma. J. Allergy Ther. 2013; 11:3–8.

7. Kolychev A.P., Mineev V.N., Bulatova N.Yu., Fedoseev G.B. Features of insulin-receptor interactions in bronchial asthma. Pulmonology. 1994; 2:48–51. / Kolychev A.P., Mineev V.N., Bulatova N.Yu., Fedoseev G.B. Insulin-receptor interactions in bronchial asthma. Pul’monologia. 1994; 2: 48–51 (in Russian).

8. Hashemzadeh M., Movahed M.R. The occurrence of asthma in hospitalized patients with type 2 diabetes mellitus. Intern. Med. J. 2009; 39(10): 699–701.

9. Sheiner E., Mazor M., Levy A. et al. Pregnancy outcome of asthmatic patients: a population-based study. J. Matern. Fetal neonate. Med. 2005; 18:237–40.

10. Rapaport M.J., Bistritzer T. , Aharoni D. Th2/Th3 cytokine secretion of first degree relatives of T1DM patients. Cytokine. 2005; 30(5): 219–227.

11. Kononenko I.V., Prokofiev S.A., Smirnova O.M. The functional state of β-cells, immunological and clinical and biochemical characteristics in patients with slowly progressive autoimmune diabetes in adults. Problems of endocrinology. 2004; 50(1): 18–22. / Kononenko I.V., Prokof’ev S.A., Smirnova O.M. Functional status of β-cells and immunological, clinical and biochemical features of adult patients with slowly-progressive autoimmune diabetes mellitus. Problemy endocrinology. 2004; 50 (1): 18–22 (in Russian).

12. Saprina T.V., Lazarenko F.E., Prokhorenko T.S. The role of Th2/Th3 imbalance of the immune response in determining the clinical features of autoimmune diabetes mellitus in adults. Diabetes. 2011; 2:12–17. / Saprina T.V., Lazarenko F.E., Prokhorenko T.S. et al. A role of Th2/Th3 immune imbalance for clinical course of diabetes mellitus in adults. Sakharny diabetes. 2011; 2:12–17 (in Russian).

13. Brealey D., Singer M. Hyperglycemia in critical illness: a review. J. Diabetes. sci. Technol. 2009; 3:1250–1260.

14. McMahon G.T., Arky R.A. Inhaled insulin for diabetes mellitus. N. Engl. J. Med. 2007; 356:497–502.

15. Mineev V.N., Bulatova N.Yu. Features of the influence of glucose inhalations on bronchial reactivity in bronchial asthma. Clinical medicine. 2001; 79(8):37–39. / Mineev V.N., Bulatova N.Yu. An influence of inhalational glucose on bronchial reactivity in patients with asthma. Clinical Meditsina. 2001; 79 (8): 37–39 (in Russian).

16. Viardot A., Gray S.T., Mackay F., Chisholm D. Potential antiinflammatory role of insulin via the preferential polarization of effector T cells towards a T helper 2 phenotype. endocrinology. 2007; 148:346–353.

17. Shore S.A., Schwartzman I.N., Mellema M.S. et al. Effect of leptin on allergic airway responses in mice. J. Allergy Clin. Immunol. 2005; 115:103–109.

18. Giannessi D., Maltinti M., Del Ry S. Adiponectin circulating levels: a new emerging biomarker of cardiovascular risk. Pharmacol. Res. 2007; 56:459–467.

19. Shore S.A., Terry R.D., Flynt L. et al. Adiponectin attenuates allergen-induced airway inflammation and hyperresponsiveness in mice. J. Allergy Clin. Immunol. 2006; 118:389–395.

20. Sherman M.S., Lazar E.J., Eichacker P. A bronchodilator action of glucagon. J. Allergy. Clin. Immunol. 1988; 81:908–911.

21. Imbruce R., Goldfedder A., ​​Maguire W. et al. The effect of glucagon on airway resistance. J.Clin. Pharmacol. 1975; 15:680–684.

22. Olsen P.C., Coelho L.P., Costa J.C. et al. Two for one: cyclic AMP mediates the anti-inflammatory and anti-spasmodic properties of the non-anesthetic lidocaine analog JMF2-1. Eur. J Pharmacol. 2012; 680:102–107.

23. Hu C.P., Zou Y.Q., Feng J.T., Li X.Z. The effect of unilateral adrenalectomy on transformation of adrenal medullary chromaffin cells in vivo: a potential mechanism of asthma pathogenesis. PLOS One. 2012; 7:e44586.

24. Scola A.M., Loxham M., Charlton S.J., Peachell P.T. The long-acting beta-adrenoceptor agonist, indacaterol, inhibits IgE-dependent responses of human lung mast cells. Br. J Pharmacol. 2009; 158:267–276.

25. Goleva E., Dunlap A., Leung D.Y. Differential control of Th2 versus Th3 cell responses by the combination of lowdose steroids with beta2-adrenergic agonists. J. Allergy Clin. Immunol. 2004; 114:183–191.

26. Giordano R., Guaraldi F., Berardelli R. et al. Glucose metabolism in patients with subclinical Cushing’s syndrome. endocrine. 2012; 41:415–423.

27. Torres R.C., Insuela D.B.R., Carvalho V.F. Mecanismos celulares e moleculares da acao antiinflamatoria dos glicocorticoides. Corpus et Scientia. 2012; 8:36–51.

28. Maneechotesuwan K., Yao X., Ito K. et al. Suppression of GATA-3 nuclear import and phosphorylation: a novel mechanism of corticosteroid action in allergic disease. PLOS Med. 2009; 6: e1000076.

29. Ammit A.J., Burgess J.K., Hirst S.J. et al. The effect of asthma therapeutics on signaling and transcriptional regulation of airway smooth muscle function. Pulm. Pharmacol. Ther. 2009; 22:446–454.

30 Barnes P.J. Biochemical basis of asthma therapy. J Biol. Chem. 2011; 286:32899–32905.

31. Rajala M.W., Obici S., Scherer P.E., Rossetti L. Adiposederived resistin and gut-derived resistin-like molecule-beta selectively impair insulin action on glucose production. J.Clin. Invest. 2003; 111:225–230.

32. Condliffe A.M., Cadwallader K.A., Walker T.R. et al. Phosphoinositide 3-kinase: a critical signaling event in pulmonary cells. Respir. Res. 2000; 1:24–29.

33. Fedoseev G.B., Trofimov V.I., Petrova M.A., red. Many-sided bronchial asthma, diagnosis, treatment and prevention. St. Petersburg: Nordmed-Izdat; 2011. / Fedoseev G.B., Trofimov V.I., Petrova M.A., eds. Multifaceted Bronchial Asthma: Diagnosis, Treatment, Prevention. St. Petersburg: Nordmed-Izdat; 2011 (in Russian).

Bronchial asthma and diabetes mellitus

Bronchial asthma and diabetes mellitus occur against the background of impaired functioning of the immune system. Diabetes mellitus develops as an autoimmune disease with the production of antibodies against the pancreas’ own cells. In bronchial asthma, plant pollen, food, animal hair, bacteria, etc. act as an antigen. The risk of developing asthma in diabetics is higher than in people without autoimmune diseases.

There is also a risk of impaired carbohydrate metabolism for asthmatics using glucocorticosteroids for treatment. With this combination, the development of diabetes as a complication of steroid therapy is less common than osteoporosis or other side effects, but all steroids and a number of other drugs used to treat bronchial asthma worsen the course of existing diabetes, as they increase blood sugar levels.

Patients with asthma who are diagnosed with steroid diabetes usually have severe asthma, which is the reason for the prescription of systemic steroids. Their use in high doses or for a long time leads to obesity. Obesity, in turn, worsens the course of diabetes.

Bronchial asthma in diabetes mellitus occurs more often in the first, insulin-dependent type. There was no association between type 2 diabetes and the incidence of asthma.

For patients with bronchial asthma, a complete cessation of smoking is necessary, since this factor leads to frequent attacks of suffocation and causes circulatory disorders, vasospasm. In diabetes mellitus, in conditions of angiopathy, smoking increases the risk of developing diabetic neuropathy, heart disease, destruction of the glomeruli of the kidneys and kidney failure.

In order to prevent complications of diabetes in the treatment of bronchial asthma, patients are recommended to:

1. Constant monitoring of blood sugar levels and dose adjustment while prescribing glucocorticoids.

2. Follow a diet that limits simple carbohydrates and foods that can cause allergic reactions.