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01.11.2004 | Article

Diffusing capacity for carbon monoxide in children with type 1 diabetes

verfasst von: M. P. Villa, M. Montesano, M. Barreto, J. Pagani, M. Stegagno, G. Multari, R. Ronchetti

Erschienen in: Diabetologia | Ausgabe 11/2004

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Abstract

Aims/hypothesis

Few data are available on lung dysfunction in children with diabetes. We studied the association of pulmonary function variables (flows, volumes and alveolar capillary diffusion) with disease-related variables in children with type 1 diabetes mellitus.

Methods

We studied 39 children with type 1 diabetes (mean age 10.9±2.6 years, disease duration 3.6±2.4 years, insulin·kg⁻¹·day⁻¹ 0.77±0.31) and 30 healthy control children (mean age 10.4±3.0 years). Pulmonary function tests included spirometry, N₂ wash-out and the single-breath diffusing capacity for carbon monoxide (DL_CO) corrected for the alveolar volume (DL_CO/V_A). Glycaemic control was assessed on the basis of HbA₁c, with HbA₁c values of 8% or less considered to indicate good glycaemic control, and HbA₁c values of 8% or more considered to indicate poor control.

Results

Children with poor glycaemic control had comparable percentage values for predicted flows and volumes but lower DL_CO/V_A values than children with good glycaemic control and healthy control children (86.7±12.6 vs 99.8±18.4 and 102.0±15.7; p<0.05). The predicted DL_CO/V_A percentages correlated with HbA₁c levels (r=−0.39, p=0.013). A multiple regression analysis (stepwise model) controlling for HbA₁c levels and other disease-related variables (age of disease onset, disease duration, daily insulin dose/kg, sex) identified HbA₁c levels as the sole predictor of DL_CO/V_A in percent.

Conclusions/interpretation

In children with type 1 diabetes, the diffusing capacity diminishes early in childhood and is associated with poor metabolic control. Although low DL_CO/V_A levels in these children probably reflect pulmonary microangiopathy induced by type 1 diabetes, other factors presumably influencing CO diffusion capacity measurements (e.g. a left shift in HbA₁c resulting in high O₂ binding and low CO binding) could explain the apparent capillary and alveolar basal membrane dysfunction.

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Titel: Diffusing capacity for carbon monoxide in children with type 1 diabetes
verfasst von: M. P. Villa
M. Montesano
M. Barreto
J. Pagani
M. Stegagno
G. Multari
R. Ronchetti
Publikationsdatum: 01.11.2004
Verlag: Springer-Verlag
Erschienen in: Diabetologia / Ausgabe 11/2004
Print ISSN: 0012-186X
Elektronische ISSN: 1432-0428
DOI: https://doi.org/10.1007/s00125-004-1548-7

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