Systematic Reviews
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Jan 15, 2025; 16(1): 97954
Published online Jan 15, 2025. doi: 10.4239/wjd.v16.i1.97954
Diabetes-inducing effects of bronchial asthma
Mohammed Al-Beltagi, Adel Salah Bediwy, Nermin Kamal Saeed, Hosameldin A Bediwy, Reem Elbeltagi
Mohammed Al-Beltagi, Department of Pediatric, Faculty of Medicine, Tanta University, Tanta 31511‎, Alghrabia, Egypt
Mohammed Al-Beltagi, Department of Pediatric, University Medical Center, King Abdulla Medical City, Arabian Gulf University, Manama 26671, Manama, Bahrain
Adel Salah Bediwy, Department of Pulmonology, Faculty of Medicine, Tanta University, Tanta ‎‎31527, Alghrabia, Egypt
Adel Salah Bediwy, Department of Pulmonology, University Medical Center, King Abdulla Medical City, Arabian Gulf University, Manama 26671, Manama, Bahrain
Nermin Kamal Saeed, Medical Microbiology Section, Department of Pathology, Salmaniya Medical Complex, ‎Ministry of Health, Kingdom of Bahrain, Manama 26671, Manama, Bahrain
Nermin Kamal Saeed, Medical Microbiology Section, Department of Pathology, Irish Royal College of Surgeon, Busaiteen 15503, Muharraq, Bahrain
Hosameldin A Bediwy, Faculty of Medicine, Tanta University, Tanta 31527, Algharbia, Egypt
Reem Elbeltagi, Department of Medicine, The Royal College of Surgeons in Ireland-Bahrain, ‎Busiateen 15503, Muharraq, Bahrain
Co-first authors: Mohammed Al-Beltagi and Adel Salah Bediwy.
Author contributions: Al-Biltagi M, Bediwy AS, Saeed NK, Bediwy HA, and Elbeltagi R collected the data, wrote the manuscript, and revised it.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Mohammed Al-Beltagi, MBChB, MD, PhD, Academic Editor, Chairman, Full Professor, Research Scientist, Department of Pediatric, Faculty of Medicine, Tanta University, Al-Bahr Street, Tanta ‎ 31511‎, Alghrabia, Egypt. mbelrem@hotmail.com
Received: June 13, 2024
Revised: October 12, 2024
Accepted: November 7, 2024
Published online: January 15, 2025
Processing time: 169 Days and 16.2 Hours
Abstract
BACKGROUND

The relationship between diabetes mellitus (DM) and asthma is complex and can impact disease trajectories.

AIM

To explore the bidirectional influences between the two conditions on clinical outcomes and disease control.

METHODS

We systematically reviewed the literature on the relationship between DM and asthma, focusing on their impacts, mechanisms, and therapeutic implications. Various studies were assessed, which investigated the effect of glycemic control on asthma outcomes, lung function, and exacerbations. The study highlighted the role of specific diabetes medications in managing asthma.

RESULTS

The results showed that poor glycemic control in diabetes can exacerbate asthma, increase hospitalizations, and reduce lung function. Conversely, severe asthma, especially in obese individuals, can complicate diabetes management and make glycemic control more difficult. The diabetes-associated mechanisms, such as inflammation, microangiopathy, and oxidative stress, can exacerbate asthma and decrease lung function. Some diabetes medications exhibit anti-inflammatory effects that show promise in mitigating asthma exacerbations.

CONCLUSION

The complex interrelationship between diabetes and asthma suggests bidirectional influences that affect disease course and outcomes. Inflammation and microvascular complications associated with diabetes may worsen asthma outcomes, while asthma severity, especially in obese individuals, complicates diabetes control. However, the current research has limitations, and more diverse longitudinal studies are required to establish causal relationships and identify effective treatment strategies for individuals with both conditions.

Keywords: Diabetes mellitus; Bronchial asthma; Glycemic control; Lung function; Asthma exacerbation; Disease interaction; Microangiopathy

Core Tip: This study explores the intricate relationship between diabetes mellitus (DM) and asthma, emphasizing their bidirectional impact. It delves into the influence of glycemic control on lung function and asthma exacerbations, highlighting how poorly controlled DM correlates with reduced lung function. The research underscores various mechanisms linking DM to asthma complications, including inflammation, microangiopathy, and insulin resistance. Medications like metformin and glucagon-like peptide 1 receptor agonists show promise in mitigating asthma exacerbations in diabetic patients. Overall, the study underscores the significance of glycemic management in ameliorating asthma outcomes and identifies potential avenues for targeted therapeutic interventions in this complex interplay between DM and asthma.