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Journal Article
Patients Diagnosed With Diabetes Are at Increased Risk for Asthma, Chronic Obstructive Pulmonary Disease, Pulmonary Fibrosis, and Pneumonia but Not Lung Cancer
2010
Overview
Patients Diagnosed With Diabetes Are at Increased Risk for Asthma, Chronic Obstructive Pulmonary Disease, Pulmonary Fibrosis,
and Pneumonia but Not Lung Cancer
Samantha F. Ehrlich , MPH ,
Charles P. Quesenberry Jr. , PHD ,
Stephen K. Van Den Eeden , PHD ,
Jun Shan , PHD and
Assiamira Ferrara , MD, PHD
From the Division of Research, Kaiser Permanente Northern California, Oakland, California.
Corresponding author: Samantha F. Ehrlich, samantha.ehrlich{at}kp.org .
Abstract
OBJECTIVE There are limited data on the risk of pulmonary disease in patients with diabetes. The aim of this study was to evaluate
and compare the incidence of asthma, chronic obstructive pulmonary disease (COPD), pulmonary fibrosis, pneumonia, and lung
cancer in patients with and without a diagnosis of diabetes.
RESEARCH DESIGN AND METHODS We conducted a retrospective, longitudinal cohort study using the electronic records of a large health plan in northern California.
Age and sex data were available for all cohort members ( n = 1,811,228). Data on confounders were available for a subcohort that responded to surveys ( n = 121,886), among whom Cox proportional hazards regression models were fit.
RESULTS Age- and sex-adjusted incidence rates and 95% CIs were calculated for members with and without diabetes in the full cohort
and the subcohort. No difference was observed for lung cancer, but the incidence of asthma, COPD, fibrosis, and pneumonia
was significantly higher in those members with a diagnosis of diabetes. These differences remained significant in regression
models adjusted for age, sex, race/ethnicity, smoking, BMI, education, alcohol consumption, and outpatient visits (asthma
hazard ratio [HR] 1.08 [95% CI 1.03–1.12], COPD HR 1.22 [1.15–1.28], pulmonary fibrosis HR 1.54 [1.31–1.81], and pneumonia
HR 1.92 [1.84–1.99]). The risk of pneumonia and COPD increased significantly with increasing A1C.
CONCLUSIONS Individuals with diabetes are at increased risk of several pulmonary conditions (asthma, COPD, fibrosis, and pneumonia) but
not lung cancer. This increased risk may be a consequence of declining lung function in patients with diabetes.
Footnotes
The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore
be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
Received May 13, 2009.
Accepted September 23, 2009.
© 2010 by the American Diabetes Association.
Publisher
American Diabetes Association
Subject
/ Aged
/ Asthma
/ Biological and medical sciences
/ Cancer
/ Diabetes
/ Diabetes Complications - epidemiology
/ Diabetes Mellitus - epidemiology
/ Diabetes Mellitus - physiopathology
/ Diabetes. Impaired glucose tolerance
/ Endocrine pancreas. Apud cells (diseases)
/ Etiopathogenesis. Screening. Investigations. Target tissue resistance
/ Female
/ fibrosis
/ Humans
/ Lung Neoplasms - epidemiology
/ Male
/ nationalities and ethnic groups
/ patients
/ Public health. Hygiene-occupational medicine
/ Pulmonary Disease, Chronic Obstructive
/ Pulmonary Disease, Chronic Obstructive - epidemiology
/ risk
/ Studies
