Type 2 diabetes can cause lung disorders, new study finds

Press release from Diabetes UK

• New research reveals for the first time that high blood sugar levels in type 2 diabetes can play a causal role in lung disorders
• Largest-ever study into the genetic basis of random ‘round-the-clock’ blood sugar levels
• Healthcare professionals should be alert to lung disorders as a potential complication of type 2 diabetes, alongside kidney disease, heart attack and stroke

New research presented at the Diabetes UK Professional Conference 2023 and funded by Diabetes UK, LongITools and others, has revealed, for the first time, that type 2 diabetes can directly cause lung complications. In the largest ever genetic study to explore how genes affect blood sugar levels and health outcomes, researchers, including the LongITools University of Surrey team, concluded that lung disorders should now be considered a complication of type 2 diabetes.

Type 2 diabetes is a complex condition where the insulin made by cells in the pancreas doesn’t work properly, or the pancreas doesn’t produce enough insulin. This can lead to dangerously high blood sugar levels, which over time can damage organs and tissues in the body, causing serious complications such as kidney failure, eye and foot problems, heart attacks and stroke. More than five million people in the UK are now living with diabetes, and 90% of these have type 2.

Previous studies have shown that lung conditions including restrictive lung disease, fibrosis and pneumonia, are more common in people with type 2 diabetes. However, until now, it was not known whether type 2 diabetes directly causes damage to the lungs or if other factors, common to both type 2 diabetes and lung conditions, are responsible.

Analysis and Findings

The team of researchers led by Professor Inga Prokopenko at the University of Surrey, on behalf of the Meta-Analysis of Glucose and Insulin-related Traits Consortium (MAGIC) consortium, analysed data from a diverse group of nearly 500,000 participants of 17 major studies, including the UK Biobank. Controlling for factors including smoking and sedentary behaviour, the team used a statistical technique called Mendelian randomisation to understand whether high blood sugar levels were linked to impaired lung function, and whether one was causing the other. Lung function was measured using two common spirometry tests used to diagnose lung conditions¹.

The analysis revealed that high blood sugar levels in people with type 2 diabetes directly impaired lung function. For example, modelling of the study data showed that an increase in average blood sugar levels from 4 mmol/L to 12 mmol/L, could result in a 20% drop in lung capacity and function.

With respiratory disease the third biggest cause of death in England², and hospital admissions for respiratory diseases in England and Wales doubling over the last 20 years³, the findings highlight the need for healthcare professionals to be vigilant to lung complications in people with type 2 diabetes. Diagnosing and treating lung disorders early could potentially save the lives of thousands of people with type 2 diabetes.

Inga Prokopenko, Professor of eOne health and co-Director of People-Centred AI Institute at the University of Surrey, said:

“Our research provides the first evidence that high blood sugar levels in type 2 diabetes, can directly lead to lung damage. We hope our discovery that impaired lung function is a complication of type 2 diabetes is the first step towards increased awareness among healthcare professionals, leading to earlier diagnosis and treatment of lung conditions.”

To read the full press release visit diabetes.org.uk.

For further media information please contact Diabetes UK’s media relations team on 020 3757 7877 or email pressteam@diabetes.org.uk.

References

¹Lung function tests included:

• Forced expiratory volume (FEV1) – a measurement of the amount of air an individual can force out of their lungs in one second.
• Forced vital capacity (FVC) – the amount of air that can be forcibly exhaled from your lungs after taking the deepest breath possible.

²Respiratory disease is the third biggest cause of death in England: NHS England » Respiratory disease

³Hospital admissions for respiratory diseases in England and Wales doubled over the last 20 years: Hospital admission trends due to respiratory diseases in England and Wales between 1999 and 2019: an ecologic study

In the media

Lung problems ‘should now be seen as complication of type 2 diabetes’, The Independent

Type 2 diabetes can lead to lung damage, research finds, The Telegraph

Paper

The paper based on this research was published in Nature Genetics in September 2023.

Lagou, V., Jiang, L., Ulrich, A. et al. GWAS of random glucose in 476,326 individuals provide insights into diabetes pathophysiology, complications and treatment stratification. Nat Genet 55, 1448–1461 (2023).