Skip to content
2000
  1. Home
  2. A-Z Publications
  3. Current Respiratory Medicine Reviews
  4. Volume 21, Issue 2
  5. Article
Volume 21, Issue 2
  • ISSN: 1573-398X
  • E-ISSN: 1875-6387

Abstract

Type 2 Diabetes Mellitus (T2DM) is a chronic condition that afflicts millions of people worldwide. T2DM correlates with increased levels of pro-inflammatory and pro-fibrotic molecules and respiratory cell injury leading to Idiopathic Pulmonary Fibrosis (IPF) development. Idiopathic pulmonary fibrosis patients with T2DM have a higher rate of progression and worse prognosis, including higher hospital stay length and mortality rate. On High-resolution Computed Tomography (HRCT), IPF patients with T2DM are more likely to exhibit the Usual Interstitial Pneumonia (UIP) pattern (reticular and honeycomb patterns) than those without T2DM. Interventions for IPF include non-pharmacological interventions, , oxygen supplementation and pulmonary rehabilitation, and pharmacological interventions, including nintedanib and pirfenidone. Antidiabetic agents, such as metformin, thiazolidinediones, and glucagon-like peptide 1, have shown anti-pulmonary fibrotic effects and to be associated with better clinical outcomes.

© 2025 Bentham Science Publishers
Loading

Article metrics loading...

/content/journals/crmr/10.2174/011573398X305467240802073225
2024-08-19
2025-06-21

  • From This Site

    /content/journals/crmr/10.2174/011573398X305467240802073225
    dcterms_title,dcterms_subject,pub_keyword
    -contentType:Contributor -contentType:Concept -contentType:Institution
    10
    5
Loading full text...

Full text loading...

References

  1. IDF Diabetes AtlasIDF Diabetes Atlas 2021 – 10TH EDITION.2021Available From: https://diabetesatlas.org/atlas/tenth-edition/
  2. PitoccoD. FusoL. Contee.g. ZaccardiF. CondoluciC. ScavoneG. IncalziR.A. GhirlandaG. The diabetic lung-A new target organ?Rev. Diabet. Stud.201291233510.1900/RDS.2012.9.2322972442
     [Google Scholar]
  3. KolahianS. LeissV. NürnbergB. Diabetic lung disease: Fact or fiction?Rev. Endocr. Metab. Disord.201920330331910.1007/s11154‑019‑09516‑w31637580
     [Google Scholar]
  4. KinneyG.L. Black-ShinnJ.L. WanE.S. MakeB. ReganE. LutzS. SolerX. SilvermanE.K. CrapoJ. HokansonJ.E. Pulmonary function reduction in diabetes with and without chronic obstructive pulmonary disease.Diabetes Care201437238939510.2337/dc13‑143524026562
     [Google Scholar]
  5. SauledaJ. NúñezB. SalaE. SorianoJ.B. Idiopathic pulmonary fibrosis: Epidemiology, natural history, phenotypes.Med. Sci. (Basel)20186411010.3390/medsci604011030501130
     [Google Scholar]
  6. BarrattS. CreamerA. HaytonC. ChaudhuriN. Idiopathic Pulmonary Fibrosis (IPF): An Overview.J. Clin. Med.20187820110.3390/jcm708020130082599
     [Google Scholar]
  7. OlsonA.L. GiffordA.H. InaseN. Fernández PérezE.R. SudaT. The epidemiology of idiopathic pulmonary fibrosis and interstitial lung diseases at risk of a progressive-fibrosing phenotype.Eur. Respir. Rev.20182715018007710.1183/16000617.0077‑201830578336
     [Google Scholar]
  8. HyldgaardC. HilbergO. BendstrupE. How does comorbidity influence survival in idiopathic pulmonary fibrosis?Respir. Med.2014108464765310.1016/j.rmed.2014.01.00824529739
     [Google Scholar]
  9. SonodaN. MorimotoA. TatsumiY. AsayamaK. OhkuboT. IzawaS. OhnoY. A prospective study of the impact of diabetes mellitus on restrictive and obstructive lung function impairment: The Saku study.Metabolism201882586410.1016/j.metabol.2017.12.00629288691
     [Google Scholar]
  10. BaiL ZhangL PanT Idiopathic pulmonary fibrosis and diabetes mellitus: A meta-analysis and systematic review.Respir Res202122117510.1186/s12931‑021‑01760‑6
     [Google Scholar]
  11. JeganathanN. MiotC. SathananthanA. SathananthanM. The association of pulmonary fibrosis with diabetes mellitus.ERJ Open Res.2020640023710.1183/23120541.00237‑202033263032
     [Google Scholar]
  12. KangQ RenJ CongJ. Diabetes mellitus and idiopathic pulmonary fibrosis: A Mendelian randomization study.BMC Pulm Med202424114210.1186/s12890‑024‑02961‑7
     [Google Scholar]
  13. LeeD.Y. NamS. The association between lung function and type 2 diabetes in koreans.Osong Public Health Res. Perspect.2020111273310.24171/j.phrp.2020.11.1.0532149039
     [Google Scholar]
  14. WangD. MaY. TongX. ZhangY. FanH. Diabetes mellitus contributes to idiopathic pulmonary fibrosis: A review from clinical appearance to possible pathogenesis.Front. Public Health2020819610.3389/fpubh.2020.0019632582606
     [Google Scholar]
  15. TalakattaG. SarikhaniM. MuhamedJ. DhanyaK. SomashekarB.S. MaheshP.A. SundaresanN. RavindraP.V. Diabetes induces fibrotic changes in the lung through the activation of TGF-β signaling pathways.Sci. Rep.2018811192010.1038/s41598‑018‑30449‑y30093732
     [Google Scholar]
  16. RajasuryaV. GunasekaranK. SuraniS. Interstitial lung disease and diabetes.World J. Diabetes202011835135710.4239/wjd.v11.i8.35132864047
     [Google Scholar]
  17. MatsubaraT. HaraF. The pulmonary function and histopathological studies of the lung in diabetes mellitus.Nihon Ika Daigaku Zasshi199158852853610.1272/jnms1923.58.5281744225
     [Google Scholar]
  18. FariñaJ. FurióV. HeM.Y. Fernandez-AceñeroM.J. Nodular fibrosis of the lung in diabetes mellitus.Vichows Archiv A Pathol Anat.1995427616310.1007/BF00203738
     [Google Scholar]
  19. WangG. HuY.X. HeM.Y. XieY.H. SuW. LongD. ZhaoR. WangJ. DaiC. LiH. SiZ.P. ChengX. LiR.M. LiZ. YangX. Gut-lung dysbiosis accompanied by diabetes mellitus leads to pulmonary fibrotic change through the NF-κB signaling pathway.Am. J. Pathol.2021191583885610.1016/j.ajpath.2021.02.01933705752
     [Google Scholar]
  20. RaghuG. Remy-JardinM. RicheldiL. ThomsonC.C. InoueY. JohkohT. KreuterM. LynchD.A. MaherT.M. MartinezF.J. Molina-MolinaM. MyersJ.L. NicholsonA.G. RyersonC.J. StrekM.E. TroyL.K. WijsenbeekM. MammenM.J. HossainT. BissellB.D. HermanD.D. HonS.M. KheirF. KhorY.H. MacreaM. AntoniouK.M. BourosD. Buendia-RoldanI. CaroF. CrestaniB. HoL. MorissetJ. OlsonA.L. PodolanczukA. PolettiV. SelmanM. EwingT. JonesS. KnightS.L. GhazipuraM. WilsonK.C. Idiopathic pulmonary fibrosis (an update) and progressive pulmonary fibrosis in adults: An Official ATS/ERS/JRS/ALAT Clinical Practice Guideline.Am. J. Respir. Crit. Care Med.20222059e18e4710.1164/rccm.202202‑0399ST35486072
     [Google Scholar]
  21. NakamuraY SudaT. Idiopathic pulmonary fibrosis: Diagnosis and clinical manifestations.Clin Med Insights Circ Respir Pulm Med20169Suppl 116371
     [Google Scholar]
  22. DavisW.A. KnuimanM. KendallP. GrangeV. DavisT.M.E. Glycemic exposure is associated with reduced pulmonary function in type 2 diabetes: The Fremantle Diabetes Study.Diabetes Care200427375275710.2337/diacare.27.3.75214988297
     [Google Scholar]
  23. KopfS. GroenerJ.B. KenderZ. FlemingT. BruneM. RiedingerC. VolkN. HerpelE. PestaD. SzendrödiJ. WielpützM.O. KauczorH.U. KatusH.A. KreuterM. NawrothP.P. Breathlessness and restrictive lung disease: An important diabetes-related feature in patients with Type 2 Diabetes.Respiration2018961294010.1159/00048890929874679
     [Google Scholar]
  24. KimY.J. ParkJ.W. KyungS.Y. LeeS.P. ChungM.P. KimY.H. LeeJ.H. KimY.C. RyuJ.S. LeeH.L. ParkC.S. UhS.T. LeeY.C. KimK.H. ChunY.J. ParkY.B. KimD.S. JegalY. LeeJ.H. ParkM.S. JeongS.H. Clinical characteristics of idiopathic pulmonary fibrosis patients with diabetes mellitus: The national survey in Korea from 2003 to 2007.J. Korean Med. Sci.201227775676010.3346/jkms.2012.27.7.75622787370
     [Google Scholar]
  25. GaliotoF. PalmucciS. AstutiG.M. VancheriA. DistefanoG. TiralongoF. LibraA. CusumanoG. BasileA. VancheriC. Complications in idiopathic pulmonary fibrosis: Focus on their clinical and radiological features.Diagnostics (Basel)202010745010.3390/diagnostics1007045032635390
     [Google Scholar]
  26. KhalidI. SherbiniN. FeteihM.N. WaliS.O. AlamoudiO.S. Al-FaifiS.M. Idiopathic pulmonary fibrosis in Saudi Arabia: Demographic, clinical, and survival data from two tertiary care hospitals.Ann. Thorac. Med.20149316817210.4103/1817‑1737.13407324987477
     [Google Scholar]
  27. KopfS. KumarV. KenderZ. HanZ. FlemingT. HerzigS. NawrothP.P. Diabetic Pneumopathy–A new diabetes-associated complication: Mechanisms, consequences and treatment considerations.Front. Endocrinol. (Lausanne)20211276520110.3389/fendo.2021.76520134899603
     [Google Scholar]
  28. MunchelJK SheaBS Diagnosis and management of idiopathic pulmonary fibrosis.R I Med J (2013)202110472629
     [Google Scholar]
  29. OnishchenkoD. MarloweR.J. NguforC.G. FaustL.J. LimperA.H. HunninghakeG.M. MartinezF.J. ChattopadhyayI. Screening for idiopathic pulmonary fibrosis using comorbidity signatures in electronic health records.Nat. Med.202228102107211610.1038/s41591‑022‑02010‑y36175678
     [Google Scholar]
  30. LeeJ.H. SongJ.W. Diagnostic approaches for idiopathic pulmonary fibrosis.Tuberc. Respir. Dis. (Seoul)2024871405110.4046/trd.2023.008737822232
     [Google Scholar]
  31. TeagueT.T. PayneS.R. KellyB.T. DempseyT.M. McCoyR.G. SangaralinghamL.R. LimperA.H. Evaluation for clinical benefit of metformin in patients with idiopathic pulmonary fibrosis and type 2 diabetes mellitus: A national claims-based cohort analysis.Respir. Res.20222319110.1186/s12931‑022‑02001‑035410255
     [Google Scholar]
  32. TsengC.H. Pioglitazone and risk of chronic obstructive pulmonary disease in patients with type 2 Diabetes Mellitus: A retrospective cohort study.Int. J. Chron. Obstruct. Pulmon. Dis.20221728529510.2147/COPD.S34579635177899
     [Google Scholar]
  33. LiuJ. LiX. LuS. ZhengX. ZhangX. ZhaoW. Glucagon-like peptide-1 (GLP-1) improved diabetic lung fibrosis via AMPK and microRNA-27a (miR-27a).Ann. Transl. Med.20219649249210.21037/atm‑21‑86933850889
     [Google Scholar]
  34. FlahertyK.R. WellsA.U. CottinV. DevarajA. InoueY. RicheldiL. WalshS.L.F. KolbM. KoschelD. MouaT. StowasserS. GoeldnerR.G. Schlenker-HercegR. BrownK.K. Nintedanib in progressive interstitial lung diseases: Data from the whole INBUILD trial.Eur. Respir. J.2022593200453810.1183/13993003.04538‑202034475231
     [Google Scholar]
  35. WijsenbeekM. SwigrisJ.J. InoueY. KreuterM. MaherT.M. SudaT. BaldwinM. MuellerH. RohrK.B. FlahertyK.R. Effects of nintedanib on symptoms in patients with progressive pulmonary fibrosis.Eur. Respir. J.2024632230075210.1183/13993003.00752‑202338135442
     [Google Scholar]
  36. WollinL. WexE. PautschA. SchnappG. HostettlerK.E. StowasserS. KolbM. Mode of action of nintedanib in the treatment of idiopathic pulmonary fibrosis.Eur. Respir. J.20154551434144510.1183/09031936.0017491425745043
     [Google Scholar]
  37. BehrJ. NathanS.D. CostabelU. AlberaC. WuytsW.A. GlassbergM.K. HallerH.Jr AlvaroG. GilbergF. SamaraK. LancasterL. Efficacy and safety of pirfenidone in advanced versus non-advanced idiopathic pulmonary fibrosis: Post-hoc analysis of six clinical studies.Adv. Ther.20234093937395510.1007/s12325‑023‑02565‑337391667
     [Google Scholar]
  38. NathanS.D. CostabelU. GlaspoleI. GlassbergM.K. LancasterL.H. LedererD.J. PereiraC.A. TrzaskomaB. MorgenthienE.A. LimbS.L. WellsA.U. Efficacy of pirfenidone in the context of multiple disease progression events in patients with idiopathic pulmonary fibrosis.Chest2019155471271910.1016/j.chest.2018.11.00830472023
     [Google Scholar]
  39. AimoA. SpitaleriG. NieriD. TavantiL.M. MeschiC. PanichellaG. LupónJ. PistelliF. CarrozziL. Bayes-GenisA. EmdinM. Pirfenidone for idiopathic pulmonary fibrosis and beyond.Card. Fail. Rev.20228e1210.15420/cfr.2021.3035516794
     [Google Scholar]
  40. LiuN. SongY. LiuT. WangH. YuN. MaH. Metformin enhanced the effect of pirfenidone on pulmonary fibrosis in mice.Clin. Respir. J.2024181e1373110.1111/crj.1373138286745
     [Google Scholar]
  41. MaherT.M. StrekM.E. Antifibrotic therapy for idiopathic pulmonary fibrosis: Time to treat.Respir. Res.201920120510.1186/s12931‑019‑1161‑431492155
     [Google Scholar]
  42. MoorC.C. MostardR.L.M. GruttersJ.C. BresserP. AertsJ.G.J.V. DirksenC.D. KimmanM.L. WijsenbeekM.S. Patient expectations, experiences and satisfaction with nintedanib and pirfenidone in idiopathic pulmonary fibrosis: A quantitative study.Respir. Res.202021119610.1186/s12931‑020‑01458‑132703201
     [Google Scholar]
  43. ChoiH.E. KimT.H. JangJ.H. JangH.J. YiJ. JungS.Y. KimD.W. LeeJ.H. The efficacy of pulmonary rehabilitation in patients with idiopathic pulmonary fibrosis.Life (Basel)202313240310.3390/life1302040336836759
     [Google Scholar]
  44. DowmanL. HillC.J. MayA. HollandA.E. Pulmonary rehabilitation for interstitial lung disease.Cochrane Database Syst. Rev.202122CD00632234559419
     [Google Scholar]
  45. NolanC.M. PolgarO. SchofieldS.J. PatelS. BarkerR.E. WalshJ.A. IngramK.A. GeorgeP.M. MolyneauxP.L. MaherT.M. ManW.D.C. Pulmonary rehabilitation in idiopathic pulmonary fibrosis and COPD.Chest2022161372873710.1016/j.chest.2021.10.02134699771
     [Google Scholar]
  46. KataokaK. NishiyamaO. OguraT. MoriY. KozuR. ArizonoS. TsudaT. TomiokaH. TomiiK. SakamotoK. IshimotoH. KagajoM. ItoH. IchikadoK. SasanoH. EdaS. AritaM. GotoY. HatajiO. FukeS. ShintaniR. HasegawaH. AndoM. OgawaT. ShiraishiM. WatanabeF. NishimuraK. SasakiT. MiyazakiS. SakaH. KondohY. Long-term effect of pulmonary rehabilitation in idiopathic pulmonary fibrosis: A randomised controlled trial.Thorax202378878479110.1136/thorax‑2022‑21979237012071
     [Google Scholar]
  47. VainshelboimB. KramerM. IzhakianS. LimaR. OliveiraJ. Physical activity and exertional desaturation are associated with mortality in idiopathic pulmonary fibrosis.J. Clin. Med.2016587310.3390/jcm508007327548238
     [Google Scholar]
  48. RyersonC.J. CayouC. ToppF. Pulmonary rehabilitation improves long-term outcomes in interstitial lung disease: A randomized controlled trial.Chest2021160411461156
     [Google Scholar]
  49. WuK. FanX. HuX. LiX. YangS. Case Report: Surgical management of idiopathic pulmonary aneurysms and review surgical approaches.Front. Cardiovasc. Med.202310133198210.3389/fcvm.2023.133198238173820
     [Google Scholar]
/content/journals/crmr/10.2174/011573398X305467240802073225
Loading
Idiopathic Pulmonary Fibrosis in Type 2 Diabetes Mellitus
Current Respiratory Medicine Reviews 21, 118 (2025); https://doi.org/10.2174/011573398X305467240802073225
/content/journals/crmr/10.2174/011573398X305467240802073225
/content/journals/crmr/10.2174/011573398X305467240802073225
Loading

Data & Media loading...


  • Article Type:     Review Article
Keyword(s): anti-pulmonary fibrotic effects; diabetes mellitus; Idiopathic pulmonary fibrosis; metformin; pulmonary rehabilitation; respiratory cell injury

Most Cited Most Cited RSS feed

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error
Please enter a valid_number test