Idiopathic Pulmonary Fibrosis in Type 2 Diabetes Mellitus

Abstract

Type 2 Diabetes Mellitus (T2DM) is a chronic condition that afflicts millions of people worldwide. T2DM correlates with increased levels of pro-inflammatory and pro-fibrotic molecules and respiratory cell injury leading to Idiopathic Pulmonary Fibrosis (IPF) development. Idiopathic pulmonary fibrosis patients with T2DM have a higher rate of progression and worse prognosis, including higher hospital stay length and mortality rate. On High-resolution Computed Tomography (HRCT), IPF patients with T2DM are more likely to exhibit the Usual Interstitial Pneumonia (UIP) pattern (reticular and honeycomb patterns) than those without T2DM. Interventions for IPF include non-pharmacological interventions, i.e., oxygen supplementation and pulmonary rehabilitation, and pharmacological interventions, including nintedanib and pirfenidone. Antidiabetic agents, such as metformin, thiazolidinediones, and glucagon-like peptide 1, have shown anti-pulmonary fibrotic effects and to be associated with better clinical outcomes.