Glucose metabolism in chronic lung disease

Chronic disease in general induces insulin resistance on glucose metabolism on hepatic and peripheral levels. Hypoxia in healthy subjects, induced by chronic altitude exposure, stimulates glucose production with decreased hepatic insulin sensitivity, but increases peripheral insulin sensitivity. Chronic obstructive lung disease (COPD) is a chronic inflammatory disease characterised by chronic or intermittent hypoxia. Therefore theoretically, COPD can be a chronic disease with unique features in peripheral insulin sensitivity. In this literature review the available data on glucose metabolism in COPD and cystic fibrosis are discussed in relation to this potential unique feature of increased peripheral insulin sensitivity despite the existence of chronic disease. The scarce data do not refute this possibility, but better studies aimed at exploring the influence of the degree of hypoxia on peripheral insulin sensitivity in chronic lung disease are necessary to unravel the role of oxygen in the regulation of peripheral glucose metabolism.