Diabetes and Lung Health

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Diabetes and Lung Health

Autumn is known for Halloween, pumpkins and falling leaves. It also happens to include Healthy Lung Month, and since we’re still in the midst of the coronavirus pandemic, it’s as good a time as any to focus on steps that you can take to make sure your lungs are as healthy as they can be.

Link between diabetes and lung disease

Diabetes can lead to many health effects, such as heart disease and kidney problems. People with diabetes are also more likely to develop pneumonia and chronic obstructive pulmonary disease (COPD). In addition, people with diabetes are often more likely to catch a cold or get the flu, and need more time to recover that people without diabetes. Let’s take a closer look at pneumonia and COPD, and steps that you can take to help prevent them.

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Pneumonia is an infection in one or both lungs that causes the air sacs in the lungs to fill up with fluid or pus. The severity of pneumonia can range from mild to severe.

What causes pneumonia?

Bacteria are the most common cause of pneumonia. Several types of bacteria are the culprit; the most common strain is streptococcus pneumoniae. Bacterial pneumonia can occur on its own or after having a cold or the flu. Viral pneumonia may be mild and go away on its own, but it can also be serious enough to require hospitalization. The SARS-CoV-2 virus that causes COVID-19 can cause pneumonia. Pneumonia caused by fungi is more common in people who have chronic health problems or weakened immune systems.

Risk factors for pneumonia

Risk factors for pneumonia include the following:

· Being age 65 and older

· Smoking

· Heavy alcohol use

· Having a lung disease

· Having a weakened immune system

· Having trouble coughing or swallowing from, say, a stroke

· Recently being sick with a cold or the flu

Symptoms of pneumonia

Symptoms on pneumonia may include the following:

· Fever and chills

· Cough

· Shortness of breath

· Rapid heartbeat

· Chest pain when breathing or coughing

· Nausea and/or vomiting

· Diarrhea

Having diabetes also puts you at risk for getting pneumonia. According to the Centers for Disease Control and Prevention (CDC), “people with diabetes are about 3 times more likely to die with flu and pneumonia.” Having diabetes means that you are more likely to be sicker longer, be hospitalized, or even die. Your risk for pneumonia, though, can depend on certain factors. High blood sugars, heart disease, kidney problems and impaired lung function can make it more likely that you’ll get pneumonia.

Pneumonia treatment

Depending on the type and severity of pneumonia, treatment may consist of:

· Antibiotics (for bacterial pneumonia)

· Cough medicine

· Medicines to reduce fever and pain

Severe cases of pneumonia may require hospitalization, especially if you are struggling to breathe, have a high or low heart rate, have confusion, and/or if you’re older than age 65. You may need supplemental oxygen, for example. You might also be admitted to the intensive care unit and in some cases, placed on a ventilator.

Preventing pneumonia

No one wants to get pneumonia and it can be particularly scary to have it if you have other health conditions, such as diabetes. You can help prevent getting pneumonia by doing the following:

· Get a flu shot every year. The flu is a common cause of pneumonia.

· Get a pneumococcal vaccine if you are age 65 or older.

· Talk to your doctor about getting vaccines that can prevent infections that can lead to pneumonia, such as pertussis, chicken pox and measles.

· Wash your hands frequently (which you’re likely already doing!).

· Don’t smoke, as smoking puts you at risk for pneumonia.

· Focus on managing your diabetes — eating healthfully, getting physical activity, taking diabetes medicine as prescribed, and checking your blood sugars regularly.

· Get enough sleep.


Chronic obstructive pulmonary disease (COPD) is a group of lung diseases that make it hard to breathe and that get worse over time. The two main types of COPD are emphysema, in which the air sacs in the lungs and the walls between them become damaged and are less elastic; and chronic bronchitis, in which the lining of the airways is constantly irritated and inflamed. Emphysema and chronic bronchitis usually occur together.

What causes COPD?

COPD is caused by long-term exposure to irritants that damage the lungs. The main cause is tobacco smoking, including cigarettes, cigars and pipes. Other irritants include secondhand smoke, air pollution and chemical fumes or dust from the environment or workplace. In a very small number of people with COPD, a genetic disorder that causes a deficiency of a protein called alpha-1-antitrypsin can cause COPD.

Risk factors for COPD

Risk factors for COPD may include the following:

· Smoking (the main risk factor)

· Long-term exposure to lung irritants

· Asthma

· Age (most people are at least 40 years of age when they develop symptoms)

· Genetics (including alpha-1-antitrypsin deficiency and a family history of COPD)

COPD symptoms

As far as COPD symptoms, many people initially don’t have any, or their symptoms may be mild. But as COPD progresses, symptoms become worse. They can include:

· Shortness of breath

· Wheezing

· Frequent coughing that produces a lot of mucus

· Chest tightness

· Low energy

· Frequent respiratory infections, such as colds and the flu

· Swelling in the legs, ankles or feet

· Weight loss

Interestingly, researchers from the Springfield Clinic in Illinois believe that there is a relationship between COPD and type 2 diabetes. COPD is thought to be a risk factor for type 2 diabetes through several mechanisms, including obesity, systemic inflammation, hypoxia (low blood oxygen) and the use of corticosteroid medications. Hyperglycemia (high blood glucose) from diabetes is linked to adverse effects on the lungs, possibly resulting in an increased risk of COPD.

COPD complications

COPD can lead to several complications, such as:

· Respiratory infections, like colds, flu and pneumonia

· Heart disease

· Pulmonary hypertension (high blood pressure in the lungs)

· Lung cancer

· Depression

COPD treatments

COPD can’t be cured, but it can be treated, and the progression of this disease can be slowed. Treatments include:

· Quitting smoking (the most important step to take!)

· Avoiding secondhand smoke and other irritants as much as possible

· Bronchodilators (inhaled medicines) to help keep the airways open and reduce inflammation

· Antibiotics, if you have a bacterial lung infection

· Oral steroids, if there is a flare-up of the disease

· Supplemental oxygen for more severe COPD

· Pulmonary rehabilitation, which is a program of exercise, nutrition advice and education

· Surgery to remove damaged lung tissue or large air spaces that can form when air sacs are damaged (a procedure called bullectomy). A lung transplant may be indicated in severe COPD cases.

Other lifestyle measures can help people with COPD feel better, stay healthy and slow damage to the lungs. Breathing exercises and relaxation techniques can help when you’re short of breath. Exercise improves muscle strength, including respiratory muscles. Eating healthy foods also helps you to maintain strength and if needed, helps you lose weight (which will make breathing easier).

You might also talk with your provider about the use of metformin, a safe and effective medicine used to treat type 2 diabetes. Studies show that metformin helps to decrease airway inflammation and induces the production of anti-inflammatory cytokines (small proteins that are part of the immune system), which can help with COPD management.

Steps to prevent COPD

How can you prevent COPD? Don’t start smoking, and if you currently smoke, talk with your doctor about ways to quit. Find resources to help you quit smoking here. Do your best to keep your blood sugars and A1C within your target range as much as possible. Talk with your doctor and diabetes educator about your diabetes treatment plan: what’s working and what isn’t, when and how often to check blood sugars, tweaking your eating plan, and coming up with ways to be more active.

For more information on lung health and disease, visit the American Lung Associations website.

Want to learn more about coronavirus and diabetes? Read “Coronavirus and Diabetes: A COVID-19 Update,” “Healthy Eating During Hard Times” and “COVID-19: Staying Safe at Work.”

Amy Campbell, MS, RD, LDN, CDCES

Amy Campbell, MS, RD, LDN, CDCES

Amy Campbell, MS, RD, LDN, CDCES on social media

A Registered Dietitian and Certified Diabetes Educator at Good Measures, LLC, where she is a CDE manager for a virtual diabetes program. Campbell is the author of Staying Healthy with Diabetes: Nutrition & Meal Planning, a co-author of 16 Myths of a Diabetic Diet, and has written for  publications including Diabetes Self-Management, Diabetes Spectrum, Clinical Diabetes, the Diabetes Research & Wellness Foundation’s newsletter, DiabeticConnect.com, and CDiabetes.com

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