Comparison of HRCT Findings in Interstitial Lung Disease among Diabetic and Non-Diabetic Patients

Abstract

Background: Diabetes mellitus (DM) is a chronic metabolic disease and its prevalence has been steadily increasing all over the world. DM and its associated micro and macrovascular complications result in significant morbidity and mortality. The microvascular complications are usually manifested as retinopathy, neuropathy, nephropathy and macrovascular complications generally affect the cardiovascular system. In addition to these complications, DM also affects the lungs because of its rich vascularity and abundance in connective tissue (collagen and elastin). DM has been found to cause microvascular complications and proliferation of extracellular connective tissue in the lungs, leading to decline in lung function in a restrictive pattern of Interstitial lung disease (ILD).
Objective: To compare HRCT patterns and severity of interstitial lung diseases in diabetic and non-diabetic patients.
Methods: A comparative cross-sectional study was conducted on patients diagnosed with interstitial lung disease, dividing them into diabetic and non-diabetic groups. All participants underwent High-Resolution Computed Tomography (HRCT) of the chest, and radiological patterns such as ground-glass opacities, reticulation, and honeycombing were systematically evaluated. The HRCT findings were then compared between both groups to assess the influence of diabetes mellitus on the pattern and severity of interstitial lung disease.
Results: Furthermore, these findings are consistent with earlier research suggesting that radiological patterns in interstitial lung disease (ILD) are more closely related to disease-specific pathophysiological mechanisms rather than systemic metabolic conditions such as diabetes. Although some studies have reported reduced lung volumes and diffusing capacity in diabetic individuals, these functional impairments may not necessarily correspond to detectable structural abnormalities on imaging. In the present study, no statistically significant association was observed between diabetes and HRCT patterns of ILD. This lack of significance may be partly explained by unassessed variables that could influence pulmonary involvement, including the duration of diabetes, level of glycemic control, presence of diabetic complications, and medication use. The heterogeneity within the diabetic group may therefore have contributed to the absence of a significant correlation.
Conclusion: The study shows that diabetic and non-diabetic patients were demographically comparable, with no significant variation in ground-glass opacities, nodules, consolidation, reticulations, or other radiological features. Fibrotic, cystic, inflammatory, and atelectatic changes, as well as honeycombing and usual interstitial pneumonia patterns, were similarly distributed in both groups. The extent of lung involvement and prevalence of bronchiectasis were also alike.