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Impact of Untreated Obstructive Sleep Apnea on Glucose Control in Type 2 Diabetes
- Source :
- American Journal of Respiratory and Critical Care Medicine. 181:507-513
- Publication Year :
- 2010
- Publisher :
- American Thoracic Society, 2010.
-
Abstract
- Rationale: Obstructive sleep apnea (OSA), a treatable sleep disorder that is associated with alterations in glucose metabolism in individuals without diabetes, is a highly prevalent comorbidity of type 2 diabetes. However, it is not known whether the severity of OSA is a predictor of glycemic control in patients with diabetes. Objectives: To determine the impact of OSA on hemoglobin A1c (HbA1c), the major clinical indicator of glycemic control, in patients with type 2 diabetes. Methods: We performed polysomnography studies and measured HbA1c in 60 consecutive patients with diabetes recruited from outpatient clinics between February 2007 and August 2009. Measurements and Main Results: A total of 77% of patients with diabetes had OSA (apnea–hypopnea index [AHI] ≥5). Increasing OSA severity was associated with poorer glucose control, after controlling for age, sex, race, body mass index, number of diabetes medications, level of exercise, years of diabetes and total sleep time. Compared with patients without OSA, the adjusted mean HbA1c was increased by 1.49% (P = 0.0028) in patients with mild OSA, 1.93% (P = 0.0033) in patients with moderate OSA, and 3.69% (P < 0.0001) in patients with severe OSA (P < 0.0001 for linear trend). Measures of OSA severity, including total AHI (P = 0.004), rapid eye movement AHI (P = 0.005), and the oxygen desaturation index during total and rapid eye movement sleep (P = 0.005 and P = 0.008, respectively) were positively correlated with increasing HbA1c levels. Conclusions: In patients with type 2 diabetes, increasing severity of OSA is associated with poorer glucose control, independent of adiposity and other confounders, with effect sizes comparable to those of widely used hypoglycemic drugs.
- Subjects :
- Adult
Blood Glucose
Male
Pulmonary and Respiratory Medicine
medicine.medical_specialty
Polysomnography
Type 2 diabetes
Critical Care and Intensive Care Medicine
stomatognathic system
Internal medicine
Diabetes mellitus
I. Sleep and Control of Ventilation
medicine
Humans
Outpatient clinic
Obesity
Aged
Glycated Hemoglobin
Sleep Apnea, Obstructive
Sleep disorder
medicine.diagnostic_test
business.industry
Sleep apnea
Middle Aged
medicine.disease
Actigraphy
nervous system diseases
respiratory tract diseases
Obstructive sleep apnea
Endocrinology
Diabetes Mellitus, Type 2
Hyperglycemia
Female
business
Body mass index
Subjects
Details
- ISSN :
- 15354970 and 1073449X
- Volume :
- 181
- Database :
- OpenAIRE
- Journal :
- American Journal of Respiratory and Critical Care Medicine
- Accession number :
- edsair.doi.dedup.....3a0ea72488c63b8b8796f6d22085b146