Genesis of concurrent diseases: do diabetes mellitus and idiopathic pulmonary fibrosis have a direct relationship?

Management and treatment of respiratory, mental health conditions, diabetes mellitus (DM), vascular diseases and cancer represent some of the greatest costs in global health.1 These conditions frequently manifest with multiple coexisting diseases. The frequency of the prevalence of multimorbidity in adults aged 50 years and over ranges from 20% to 50%.2 Investigating the effect of the comorbidity is complicated due to the lack of consensus about how primary conditions directly or indirectly impact these comorbidities. When looking at the complexity of the comorbidities, researchers look at the nature of the health condition, the importance of the co-occurring conditions, the chronology of the presentation of the conditions and the total burden of the combined diseases.3 The nature of the first diagnosed pulmonary disease could play a major role in the establishment of comorbidities and their progression. Patients diagnosed with DM are reported to be at a significantly increased risk of developing several pulmonary diseases, including idiopathic pulmonary fibrosis (IPF), asthma, chronic obstructive pulmonary disease and pneumonia.4 This may be due to the impact of DM on blood vessel function (such as endothelial dysfunction, vascular remodelling and reduced pulmonary vascular reactivity) that could impair lung function and increase susceptibility to infections.5 DM and IPF have similar …