Background: Knowledge regarding the association of the metabolic syndrome (MetS) in patients with lung diseases is limited. Lungs may suffer from diabetic microvascular complications. Also, small airways area is known as a silent zone affected in the early beginning of the obstructive lung diseases. Understanding of how these conditions influence each other could contribute to the improvement of the clinical management of patients.

Material and method: After obtaining ethical approval and patients? consent, we prospectively included 54 consecutive patients with a history of type 2 Diabetes admitted at the Clinical Emergency County Hospital Craiova in January 2023. All met the diagnostic criteria for MetS according to the National Cholesterol Education Program's Adult Treatment Panel III guidelines. We recorded past medical history, smoking habits, general blood testing, body mass index (BMI), spirometry, chest X-ray.

Results: Of all, 29 (53.7%) were women; the average age was 60.2 years; 25 (46.29%) were non-smokers, 24% active smokers and 29.62% ex-smokers; 16.66% had normal BMI, 38.88% were overweight and 44.44% were obese. The median HbA1c was 9.38%. Spirometry evidenced 5 restrictive patterns, 1 obstructive, 1 mixed disfunction and 13 (24%) with FEF 25-75 <65% of normal. In the group with bad pulmonary function tests 75% had HbA1c >9% and 70% had different stages of diabetic retinophaty.

Conclusions: There is a strong correlation between the poor glycemic control and the impairment of lung function possible related to microvascular changes. Spirometry must be part of the Diabetes management plan.