Diabetes Respiratory System

Is there a direct relationship between diabetes and the respiratory system? Do you think that an autoimmune disease could affect the way a person breaths? Could it cause a specific breathing pattern? These are questions that people may not give much thought to especially if they are not studying respiratory however, giving thought to these questions may help to inform patients and people who are diagnosed with diabetes how their disease could affect the way they breath in certain situations.
Subjects and Methods
“Diabetes Mellitus is considered as a metabolic disorder of multiple etiologies (genetic and environmental) (1)”. With diabetes there are different types such as, type 1, type 2, and gestational diabetes. Type 1 is caused by “insulin

deficiency caused by autoimmune destruction of beta cells in the islets of pancreas (1)”. With this specific type, the pancreas is not producing any insulin causing variation with patients’ blood glucose levels. Type 2 diabetes can develop when the pancreas is producing a little or no insulin at all. “It is a common type of diabetes and usually develops after the age of 40 (1)”. Type 2 diabetes is also commonly seen in patients who suffer from obesity. Gestational diabetes is a type of diabetes that develops when women become pregnant. These types of patients can live with diabetes the rest of their life after the delivery of their baby, or the diabetes could simply go away once the infant is born. Even though there are different types of diabetes, they all have one thing in common, and that is that the pancreas is not doing the job that it was designed to do and that either way the patient is at higher risk for respiratory related complications.

The respiratory system in the human body is made up of primary organs called the lungs. The lungs have a big responsibility of helping the body take in oxygen and release carbon dioxide, as we breathe. This is also known as gas exchange. Respiratory care as explained in the Egan’s book says, “Respiratory care, also known as respiratory therapy has been defined as the healthcare discipline that specializes in the promotion of optimal cardiopulmonary function and health (2)”. As respiratory therapist, we help to make sure that patients with respiratory needs are fully taken care of, whether they need something as simple as an inhaler, or whether they need something a little more serious such as a ventilator. With the respiratory system, a major part of the system is breath sounds. So many things around us can affect the way we breath whether it be external (environmental) or internal like an allergy. The way we breathe has a lot to do with our quality of life because if we are not breathing well, then our day to day living would be affected. Just like what will be discussed coming up, even a complication with a disease such as diabetes can affect the way a diabetic person may breathe and that particular breath sound tells respiratory therapist a lot about what could be going on with the patient. Breathing is very important and we have to make sure we inform patients what signs to look for when their breathing could be affected so that we can catch whatever is affecting it early so maybe severe complications do not develop.

After going over diabetes and the respiratory system in detail, it is shown just how serious both conditions are.

When mixing the two together for example, a diabetic patient having respiratory issues, different situations could potentially become more serious than if a non-diabetic patient contracted a respiratory problem. In the beginning the question was asked whether or not diabetes could affect the respiratory system. The answer to that question is, yes. Diabetes can affect the respiratory system in a number of ways. Diabetes can affect your breathing pattern when in Ketoacidosis, it can alter the results of a Pulmonary function test (PFT), and statistics show that diabetes can make a patient a higher risk for certain respiratory infections such as tuberculosis, asthma, COPD, and hospitalized pneumonia. There are many different types of breathing patterns that respiratory therapist would classify as normal and abnormal. A specific abnormal breath sound that would be seen in a patient who was in diabetic ketoacidosis (DKA) would be called kussmaul breath sound (3). This particular breath sound would be characterized as a deep and fast respiration rate because of the metabolic acidosis (2). With pulmonary function of the lungs recent studies have shown, “significant reduction in pulmonary functions among the diabetic and non-diabetic smokers and non-smokers, which revealed significant impact of diabetes on pulmonary function independent of smoking(4)”. This shows that

having diabetes and being a smoker can alter the results of a PFT test significantly. The actual statistics for the diabetics at a higher risk for pulmonary conditions are as follows, 8% are more likely to have or develop asthma, 22% of diabetics are more likely to have chronic obstructive pulmonary disease (COPD), 54% are more likely to have pulmonary fibrosis, which is a disease where the scarring can interfere with your ability to breath, and lastly, diabetics are twice as likely to be hospitalized for pneumonia (5). These statistics prove that having diabetes can cause a person a lot of problems when it comes to the respiratory system. Being a diabetic can make a person more susceptible to things and could take a while to fully healed compared to that of a non-diabetic. There are a couple of different methods that can be requested to help improve a diabetic’s lung function. One major one is that you should not be smoking. You should not smoke anyway, but especially if you are a diabetic because it can affect your body more negatively than a non-diabetic. It is said, “If you have diabetes, smoking harms more than your lungs. Smoking also increases your risk for serious complications, such as poor blood flow, nerve damage, blindness, kidney disease, and heart disease (5)”. Research shows that just by simply quitting smoking, “it will improve blood glucose levels and insulin resistance (5)”. Another method to request is that the diabetic patient checks often and keeps a close watch on their blood glucose levels. Some studies have been done and the results show that the higher the blood glucose is, the worse the lung function gets. We want to make sure as therapist that they are keeping their blood sugars under control. To do that leads me to my last method, making sure the patient sees an endocrinologist regularly to make sure blood glucose levels are in the correct range and that there are not any further complications arising.
Results
By looking at these different conditions and keeping a watch for signs and symptoms worsening in diabetic patients with respiratory issues, we may be able to prevent or stop a complication from the two of them meshing together. If the patient takes the recommendations of smoking cessation, monitoring blood glucose levels and regular checkups with the doctor, then there is a good chance that there will be positive results. Their blood glucose levels would improve, their lung function would become stronger, and their risk for other infections and complications would significantly decrease. If the patient is compliant with the recommendations suggested, they could help them self by prolonging their life and their quality of life.

Conclusion/Discussion-Summary
In conclusion, it is proven that two completely different conditions in the body can work together and have a negative result on a patient.

With diabetes, the disease itself has enough to keep a patient busy with management of the condition. The constant blood glucose checks, appropriate diet management, and variation in medication and doses to keep blood glucose levels within an appropriate range is enough stress to keep someone busy. When adding in a respiratory issue on top of all of that, that is a whole other situation in itself that needs to be monitored and kept up with to keep a patient from declining too fast. That is why adhering to those specific measures could help someone managing their diabetes and their respiratory issues better so that other sever complications may not arise. Just because someone has diabetes does not necessarily mean they will develop a respiratory problem, but smoking and not taking proper care of their self could make it more likely to become a problem. The best thing to do is not smoke, diabetic or not, and to monitor diabetes as closely as can and a healthier life is what will be

experienced.