THE EFFECT OF REPAGLINIDE AND METFORMIN ON EXTERNAL RESPIRATORY FUNCTION IN PATIENTS WITH DIABETES AND ISCHEMIC HEART DISEASE ASSOCIATED WITH OBESITY

Abstract

Introduction: Over the past 20 years, numerous studies have examined the state of the bronchopulmonary system in type 2 diabetes mellitus (T2DM), but findings remain inconsistent. Some researchers report decreased external respiratory function (ERF) linked to metabolic shifts and disease complications, while others associate it with vascular pathology. There is also evidence of increased pulmonary ventilation in diabetes. The implementation of optimal glucose-lowering therapies to prevent complications, including pulmonary issues, remains a key concern in modern medicine. The aim of the study is to evaluate the functional state of the external ventilation system in patients with type 2 diabetes mellitus in combination with coronary heart disease and obesity during treatment with repaglinide and metformin. Materials and Methods: A 3–3.5-year observational study included 120 patients. The effect of repaglinide or metformin on patients with diabetes and concomitant diseases such as coronary heart disease and obesity has been studied. The data was analyzed using the following methods: computer spirometry and fiber-optic bronchoscopy. Results: Patients with T2DM, especially those with IHD and obesity, showed both restrictive and obstructive pulmonary disorders, impaired gas exchange, and ventilation-perfusion mismatch. Repaglinide improved respiratory parameters, while metformin led to worsened spirometry indicators and increased bronchial resistance in most cases. Bronchoscopic findings confirmed nonspecific bronchial mucosal changes in 29.4% of patients. Conclusion: Bronchopulmonary impairments in T2DM are primarily due to reduced ERF and increased bronchial resistance. Repaglinide appears more effective than metformin or gliclazide in improving respiratory function.