Association between Asthma and Type 2 Diabetes Mellitus: Mechanisms and Impact on Asthma Control—A Literature Review

Abstract

The study aimed to analyze the scientific production on the association between asthma and type 2 diabetes mellitus (T2DM) in adults, the mechanisms that explain this association, and its impact on asthma control. A literature review of scientific articles indexed in the MEDLINE/PUBMED, BVS, CINAHL, Cochrane Library, and Web of Science databases was carried out, considering publications from January 2009 to December 2019, using the following descriptors: “asthma”, “type 2 diabetes”, “adult,” and “association”. Of 962 articles found, 18 were included because they met the eligibility criteria. It is suggested that the association between asthma and T2DM is caused by low-grade systemic inflammation (7 articles) or the use of corticosteroids (7 articles). It is noticed that there is a limited scientific production regarding the consequences of this association for the control of asthma (5 articles). It is concluded that asthma and T2DM are two common chronic conditions of increasing prevalence and that often coexist in the same patient. It is suggested that this coexistence worsens asthma control. Therefore, the study may support public policies and clinical health practices that value the approach of comorbidities associated with asthma such as T2DM, in order to minimize additional health risks and reduce the quality of life.

An In-Depth Study of TCA cycles, OPA1, S6K1, ATPase, TLR4, MHC-class-I, GCs, and IFNs Biosynthesis, and Their Roles of Deficiency in Diabetes, Asthma, Cancer, etc. and the NAD Roles in their Activities

“…Where, there are limited data on the risk of pulmonary disease in patients with diabetes [22]. And it is concluded that asthma and T2DM are the two common chronic conditions of increasing prevalence and that often coexist in the same patient [23]. Also, it has been reported that: Prediabetes and diabetes have been recently identified as risk factors for asthma exacerbations in adults [24].…”

Asthma and comorbidities: recent advances

“…According to scientific evidence, asthma and T2DM are linked to low -grade systemic inflammation, which may be dependent or independent of adiposity. 6, 71 As already mentioned, systemic inflammatory markers are elevated in obesity. 9 TNF -α and IL -6 promote T2 cell development and the production of cytokines such as IL -4 and IL -5, which are implicated in the usual inflammation seen in eosinophilic asthma.…”

“…72 However, it is unclear whether insulin resistance is a cause of asthma or just the outcome of the activity of inflammatory mediators implicated in the pathophysiology of the disease. 71 In any case, by blocking neuronal M 2 muscarinic receptors and boosting acetylcholine release from airway parasympathetic neurons, hyperinsulinemia enhances vagally mediated bronchoconstriction. 73 T2DM as a comorbidity may be managed using corticosteroids, which may result in a dose -dependent increase in serum glucose concentration.…”

“…9 TNF -α and IL -6 promote T2 cell development and the production of cytokines such as IL -4 and IL -5, which are implicated in the usual inflammation seen in eosinophilic asthma. 6, 71 These cytokines can also induce T2 cell development into T17 cells, and an obese target population with T2DM and severe neutrophilic asthma has a milieu rich in T17 cells and increased levels of IL -17. Furthermore, when TNF--α interacts synergistically with IL -6, it causes an increase in leptin and resistin circulation levels, favoring higher peripheral insulin resistance by blocking signaling through the insulin receptor, thereby increasing the risk of T2DM.…”

PathGPS: Discover shared genetic architecture using biobank data

“…As for asthma, T lymphocytes are critical to the development of asthma 21 . The co-occurrence of diabetes and asthma may be attributed to the shared immunological pathways 22 . Regarding the genetic architecture, our analysis confirm many existing discoveries, such as the association between HERC2 and hair color 23 , PELO and red blood cells 24 , and NME7 and venous thromboembolism 25 .…”