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5 Diagnosis Physicians typically consider COPD in patients with chronic cough, sputum production, shortness of breath, decreased exercise tolerance, and a history of exposure to tobacco smoke (GOLD 2011)

23 Diabetes Mellitus Diabetes increases the risk of developing symptomatic and asymptomatic PAD by 1.5- to 4-fold and leads to an increased risk of cardiovascular events and early mortality

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Previous research has shown that immuno-metabolic dysregulations map more consistently to symptoms of the atypical spectrum characterized by altered energy intake/output (in particular the reversed neurovegetative symptoms of hyperphagia, hypersomnia with leaden paralysis and fatigue) [2] and symptoms of anhedonia [33]