Diabetes, both type 1 and 2, can adversely affect our breathing in many ways.
The risks of having breathing difficulties can be regulated by maintaining diabetes under control and by having a healthy body weight.
How Diabetes (can) affects Breathing
1 :: Kussmaul Breathing Kussmaul Breathing is a type of breathing that is characterized by a deep, labored, grasping and desperate breathing and is often associated with Diabetic Ketoacidosis and Kidney failure (Diabetic complication). Kussmaul Breathing is triggered when carbon dioxide level in blood plummets due to increased depth and reduced rate of breathing.
Diabetic Ketoacidosis induced Kussmaul Breathing is more likely to affect patients with type I Diabetes as they have little or no insulin. But, it can be seen in type 2 Diabetes when their blood sugar levels are extremely high.
Diabetic ketoacidosis and how it affect Breathing Diabetic ketoacidosis, a life threatening condition, starts when body cells start breaking down fat and muscle to perform even the basic bodily functions because of low insulin levels, induced by Kussmaul Breathing. Although ketones give energy to the cells, they are acidic in nature and can cause acidosis of the blood.
Normally the body balances the pH levels by excreting/filtering excess acids through Kidneys. But if kidneys fail to excrete acids or if level of acids is too high for kidneys to process, body compensates this filtration through respiration.
In the beginning, respiration becomes rapid and shallow, but as the acidosis progresses it becomes deep, slow and labored. In less severe cases, Breathing comes back to normal once acidosis is fully compensated. But in the severe cases it can lead to coma or can even be fatal.
2 :: Shortness of Breath Diabetes on its own cannot cause shortness of Breath but its complications can certainly do. Shortness of Breath is commonly seen in 40% of Diabetic patient who develop Kidney disease (Nephropathy).
Chronic kidney pathology can lead to accumulation of fluids in the lungs, which can reduce surface area of lungs used for diffusion of gases aka Breathing. Diabetes can also lead to anemia, which by reducing RBC count can decrease oxygen carrying capacity of the blood.
Diabetic ketoacidosis, heart diseases, various lung conditions and obesity can also lead to shortness of breath.
3 :: Obstructive Sleep Apnea (OSA) According to a study published in Journal of Clinical Endocrinology and Metabolism, OSA is a common complication of obese diabetics, and the researchers have also found that treating OSA may improve insulin responsiveness.
What is Apnea? Apnea is cessation of airflow in and out of lungs occurs because of relaxation of upper respiratory muscles during sleep, which allows tonsils and adenoids to collapse into airways and obstruct the airflow.
Sleep Apnea can cause frequent arousals and sleep disruption, which in turn can affect glucose tolerance and insulin resistance and can worsen diabetes symptoms.
According to a study published in Family Medicine 2013, people suffering from type 2 Diabetes have 50% chances of having OSA.
4 :: Other Diabetes induced lung function issues A 2009 study published in Diabetic Care, compared the health records of more than 1.8 million people with and without diabetes in a retrospective cohort study.
- Incidence of asthma is 8% more in diabetics than non-diabetics.
- Incidence of COPD is 22% more in diabetics than non-diabetics.
- Incidence of pulmonary fibrosis is 54%.
- Patients with diabetes are twice more likely to have pneumonia-related hospitalization than non-diabetics.
- Diabetics’ significantly lower lung functions as compared to age-matched non-diabetics.
- Diabetics generally have 3-10% lower lung functions than normal adults.
- It you are otherwise healthy, reduced lung function won’t cause much trouble. But if you are obese, have underlying heart, lung and/or kidney disease then reduced lung function can interfere with your daily life.
How diabetes affects lung functions?
- Diabetes by increasing risk of inflammation of airways can lead to chronic airflow obstruction.
- Diabetes can cause microangiopathy or disease of small blood vessels, which can cause fibrosis and thickening of lining of blood vessels and basal laminae of blood capillaries. All of these factors can reduce blood flow and oxygen to the lungs, which can affect lung functions.
- Reduced elasticity caused by restriction of chest wall expansion as a result of altered collagen metabolism as seen in diabetics.
- Involvement of respiratory muscle due to diabetic neuropathy of thoracic nerves.
- Poor muscle strength and endurance attributed to increased protein catabolism commonly seen in uncontrolled diabetes.