Type 2 Diabetes Mellitus and Asthma: Pathomechanisms of Their Association and Clinical Implications

Abstract

Type 2 diabetes mellitus (T2DM) and asthma are chronic illnesses concomitantly present in a significant percentage of the population. Their comorbidity is associated with poor disease control and lower quality of life, thus imposing a substantial medical and economic burden worldwide. This review investigates the association between asthma and T2DM, in terms of pathogenesis, clinical outcomes, and therapeutic opportunities. Our review found an increased risk of asthma among diabetics, and vice versa. Having diabetes and poor glycemic control is associated with an increased rate of asthma exacerbations and increased mortality among those hospitalized for asthma exacerbations. The mechanisms postulated for the diabetes-asthma association include chronic low-grade inflammation, obesity, hyperinsulinemia, and possibly diabetic pneumopathy. Usage of metformin, which is the first-line drug for type 2 diabetes, was found to be associated with a decreased asthma occurrence, asthma exacerbations, and asthma-related hospitalizations. Glucagon-like peptide 1 receptor agonists were also found to be associated with a lower occurrence of asthma exacerbations. Thiazolidinediones are also associated with lower rates of asthma exacerbations, but their clinical efficacy for the same was suggested to be limited. This literature review supports a partly causative association between asthma and diabetes. This comorbidity leads to poor patient compliance, worse disease outcomes, and poor quality of life. Thus, further studies are warranted to explore the prognostic implications, therapeutic opportunities, and specific clinical practice algorithms for patients with concurrent asthma and type 2 diabetes mellitus.

Factors Affecting Usage of a Digital Asthma Monitoring Application by Old-Age Asthmatics Living in Inner Central Portugal

“…26 It is also possible that type 2 diabetes mellitus and asthma are reciprocal risk factors and this may be more relevant in more severe disease. 27 This was the case in our study, since a high proportion of patients with more severe asthma in Non-users Group had diabetes and, in fact, all patients with concurrent severe asthma and diabetes were in this Group.…”

Risk factors for hospitalization due to exacerbations among adult asthma patients in a district of Sri Lanka: a case‒control study.

“…The presence of diabetes mellitus and symptomatic GORD as comorbidities was associated with an increased risk of asthma-related hospitalizations, which was in line with the ndings of several previous studies. 9,22,23 These ndings indicate the importance of maintaining good control of diabetes and GORD symptoms among asthma patients to prevent asthma-related hospitalizations.…”

Risk factors for hospitalisation due to exacerbations among adult asthma patients in a district of Sri Lanka: a case control study

“…Presence of diabetes mellitus and symptomatic GORD as comorbidities were associated with an increased risk in asthma-related hospitalisations which was in line with several previous studies. 9,22,23 This indicates the importance of maintaining good control of diabetes and GORD symptoms among asthma patients in preventing asthma-related hospitalisations.…”