Interstitial lung diseases and diabetes mellitus: an analysis of the relationship between these multifactorial conditions

The effect of carbohydrate metabolism disorders on interstitial lung diseases is poorly understood. Diabetes mellitus (DM) is a chronic metabolic disorder with growing global prevalence. The progression of DM is accompanied by the development of microvascular and macrovascular complications, which significantly contribute to morbidity and mortality. Microvascular complications typically manifest as retinopathy, neuropathy, and nephropathy, whereas macrovascular complications primarily affect the cardiovascular system. In addition to these well-recognized complications, DM also affects the lungs, owing to their extensive vascular network, rich blood supply, and abundance of connective tissue components (collagen and elastin). Chronic hyperglycemia has been shown to induce microangiopathy and excessive extracellular matrix deposition in the pulmonary interstitium, resulting in a restrictive pattern of ventilatory impairment. Interstitial lung diseases (ILDs) comprise a heterogeneous group of disorders characterized by varying degrees of inflammation and fibrosis within the lung parenchyma. Among them, idiopathic pulmonary fibrosis (IPF) is one of the most common forms of idiopathic interstitial pneumonia and is associated with a high mortality rate. IPF is a chronic, progressive fibrotic disease leading to progressive respiratory failure. The aim of the review was to consider the lungs as a target organ in diabetes mellitus and to analyze the possible relationship between DM and ILDs, with particular emphasis on IPF. Сonclusion. Diabetic pneumopathy represents a progressive pulmonary disorder resulting from microvascular complications associated with diabetes. Early recognition of this complication and strict glycemic control may help prevent disease progression and alleviate debilitating pulmonary symptoms associated with diabetic lung involvement.

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