<b>Impact of Glycemic Control on Asthma Exacerbation, Asthma Control, and Lung Function in Diabetic Patients: A Systematic Review</b>
Bibliographic record
Abstract
Background: Asthma and diabetes mellitus frequently coexist and may interact through metabolic and inflammatory pathways that influence exacerbation risk and pulmonary function. Glycemic dysregulation has been proposed as a contributor to poorer asthma outcomes, yet the clinical evidence has not been consistently synthesized across outcome domains. Objective: To systematically evaluate the impact of glycemic control on asthma exacerbations, asthma control, asthma-related healthcare utilization, and lung function in individuals with asthma and diabetes mellitus or glycemic dysfunction. Methods: A PRISMA-compliant systematic review was conducted using PubMed/MEDLINE, Scopus, Web of Science, and Google Scholar to identify original observational and interventional studies published through March 2025. Eligible studies assessed glycemic status using HbA1c and/or blood glucose indices and reported asthma-related outcomes including exacerbations, emergency department visits, hospitalization, asthma control measures, and spirometric parameters (FEV₁, FVC, vital capacity). Methodological quality was assessed using the Newcastle–Ottawa Scale. Due to heterogeneity in exposure definitions, outcomes, and effect reporting, findings were synthesized narratively. Results: Five studies met inclusion criteria. Across studies, poorer glycemic control was generally associated with lower lung function and increased risk of asthma-related hospitalization. Higher HbA1c correlated inversely with spirometric indices, including FEV₁ and FVC. Population-based evidence indicated elevated HbA1c, including levels in prediabetes and diabetes ranges, was associated with higher odds of asthma-related hospitalization. Metformin exposure was associated with reduced hazards of asthma-related emergency department visits and hospitalization in a large retrospective cohort. Conclusion: Poor glycemic status is associated with increased asthma morbidity and reduced lung function. Optimizing glycemic control may be clinically relevant in integrated asthma–diabetes management, although higher-quality prospective studies and trials are needed to establish causality.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.009 | 0.040 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.007 | 0.008 |
| Bibliometrics | 0.006 | 0.008 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".