Hyperventilation In Patients With Newly Diagnosed Type 2 Diabetes Mellitus

Objective: Carbon dioxide（CO₂） is an end product of cellular respiration in humans that obtain energy by breaking down sugars, fats and amino acids with oxygen as part of their metabolism. Under high concentration of CO₂, it will make some people feel dizzying, headache, even unconsciousness within a few minutes to an hour. However, numerous medical studies show that the main physiological effect of hyperventilation is CO₂ deficiency. And it associated with asthma, heart disease, cancer, diabetes mellitus, and many other chronic diseases. The aim of this study was to evaluate the effect of alveolar carbon dioxide on diabetic control in newly diagnosed Type 2 diabetes mellitus（T2DM）.Methods: In this multi-center, controlled observational study, standardized clinical data on consecutive patients with newly diagnosed type 2 diabetes from each of 4 hospitals（The Affiliated Hospital of Guilin Medical University, The Nanxishan Hospital of Guangxi Zhuang Autonomous Region, The Second People’s Hospital of Guilin and The 303 Hospital of people’s Liberation Army） were recruited. A total of 60 patients meeting the inclusion criteria were labelled as diabetics group and the control group consisted of 14 healthy participants who were endocrinologist and nurse working in the same departments of endocrinology. Clinical data included age, sex, height, weight, body mass index（BMI）, breathing rate, breath-holding time（BHT）, Hb A1 c, fasting blood glucose（FBG） and two-hour postprandial blood glucose（2-h PG）. Statistical analysis was performed using SPSS（version 19.0）. Data were expressed as mean ± standard deviation, correlation relevance（r） and P value.Results: The BHT referred to the normal breath-holding time after usual expiration at rest,and BHT of T2 DM group was shorter than control group（18.8±7.5 versus 36.3±7.5 seconds, P<0.0001）, decreased respectively 48.2%, as well as the a CO₂%（4.4±0.4 versus 5.3±0.4%, P<0.0001） and a CO₂ pressure（33.7±2.8 versus 40.4±2.9 mm Hg, P<0.0001）.The breathing rate was higher in the T2 DM group than controls（21.0±4.5 versus 14.2±3.3 times/minute, P<0.0001）. BHT, a CO₂%, a CO₂ pressure were negatively correlated with FBG（r =-0.032, P=0.806）, 2-h PG（r =-0.294, P=0.023） and Hb A1c（r =-0.237, P=0.359）; body weight, BMI, breathing rate were positively correlated with FBG, 2-h PG and Hb A1 c. Please revise according to the Chinese version.Conclusions: The hyperventilation in Type 2 diabetes is characterized by increased breath rates and ventilation volumes coupled with decreased breath-holding time and alveolar carbon dioxide. Increasing alveolar carbon dioxide may be a potential therapeutic strategy to correct hyperventilation for the betterment of diabetes care. Compared with the molecule nitric oxide（NO） localized within blood vessels, carbon dioxide represents one of the most ubiquitous hormones in human beings.