Prevalence and incidence of co-morbid lung disease associated with type 2 diabetes from the UK Biobank

Aim: This analysis examined the prevalence and incidence of type 2 diabetes mellitus (T2DM) and co-morbid lung disease in the UK Biobank population. Methods: Non-communicable inflammatory lung diseases, body mass index (BMI), age, glycated haemoglobin (HbA1c), sex, smoking status, diabetes status, forced expiratory volume in one second (FEV1), and forced vital capacity (FVC) data were obtained. Participants were categorised by BMI: lean (18.5–24.9 kg/m2), overweight (25–29.9 kg/m2), and obese (≥ 30 kg/m2). Fisher’s exact test identified lung disease prevalence and incidence. Kruskal-Wallis assessed lung function variance and its correlation with HbA1c. Cox regression analysed the impact of confounders on time to lung disease events. Results: Overweight and obesity increased the prevalence and incidence of chronic obstructive pulmonary disease, asthma, and bronchitis, but this was not evident in cases of bronchiectasis in those without T2DM (P < 0.05–0.0001). Conversely, T2DM increased lung disease risk across all BMIs (P < 0.0001) and reduced FEV1 and FVC even after HbA1c normalisation (P < 0.0001). FEV1 and FEV1/FVC were negatively correlated with HbA1c. Age, diabetes, being a woman, smoking, reduced FEV1 and FEV1/FVC ratio, but not BMI, were factors in lung disease development in T2DM. Conclusions: Inflammatory lung conditions are more common in T2DM patients, regardless of BMI. The pattern of lung decline suggests restrictive impairment, despite a high risk of obstructive disorders. This data adds to the evidence that the lungs are a target organ of diabetes damage.