Assessment of dyspneic sensation in patients with type 2 diabetes

Abstract

Diabetes complications; Questionnaires; Respiratory symptoms

Complicaciones de la diabetes; Questionarios; Síntomas respiratorios

Complicacions de la diabetis; Qüestionaris; Símptomes respiratoris

Introduction: Individuals with type 2 diabetes (T2D) should be considered a susceptible group for pulmonary dysfunction. So, we aimed to evaluate the sensation of breathlessness in this population by administering two well-validated questionnaires. Methods: This is a crosssectional study with 592 people without known respiratory disease (353 with T2D) who answered the modified Medical Research Council (mMRC) questionnaire. In addition, 47% also responded to the St George Respiratory Questionnaire, a specific instrument designed to be applied to patients with obstructive airway disease. Results: Patients with T2D showed a higher mMRC score in comparison to the control group [1.0 (0.0 – 4.0) vs. 0.0 (0.0 – 4.0), p<0.001]. A higher prevalence of subjects with mMRC ≥2 was observed in T2D that in the control group (20.2% vs. 11.6%, p=0.004). Participants with T2D and mMRC ≥2 showed a higher HbA1c (8.2 ± 1.6% vs. 7.8 ± 1.6%, p=0.048), longer T2D evolution and higher prevalence of nephropathy. In the multivariate analysis, the presence of T2D [OR=1.95 (1.19 to 3.22), p=0.008] in all the population, and HbA1c [OR=1.19 (1.01 to 1.41), p=0.034] and the presence of diabetic nephropathy [OR=2.00 (1.14 to 3.52), p=0.015] in patients with T2D, predicted a mMRC ≥2. Finally, no differences were observed regarding the SGRQ score among groups. Conclusions: Patients with T2D showed a greater sensation of dyspnea than subjects with normal carbohydrate metabolism. Risk factors included poor metabolic control and the presence of renal disease.

This research was supported by grants from Instituto de Salud Carlos III (PI15/00260), Fondos FEDER “Una manera de hacer Europa”), and Sociedad Española de Endocrinología y Nutrición. CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM) is an initiative of the Instituto Carlos III.