Research
SDB and type 2 diabetes
1. Independent Association
- SDB is independently associated with insulin resistance and DM2 15-17
- Insulin resistance correlated with increasing severity SDB 18,19
2. Impact of CPAP therapy on glucose control
Preliminary studies indicate that effective treatment of SDB with n-CPAP in type 2 diabetic patients results in a statistically significant improvement in glycemic control that persists long-term (3-4 months) 20,21
Following 48 hours of CPAP therapy, patients with SDB showed significant improvements in insulin sensitivity, which was maintained long-term (3 months).
Following CPAP therapy patients with SDB and type 2 diabetes showed a significant improvement in post-prandial glucoses that are maintained long-term.
3. Impact of CPAP therapy on hypertension
CPAP therapy in patients with SDB has been associated with a fall in mean arterial blood pressure of 10mmHg, a drop predicted to reduce coronary heart disease event risk by 37% and stroke risk by 56% 22
Next steps
- Test your type 2 diabetic patients for OSA
- Initiate treatment or refer to a Sleep Specialist for further investigation
References
15
Punjabi NM, at al.. Sleep-disordered breathing, glucose intolerance, and insulin resistance: the Sleep Heart Health Study. Am J Epidemiol 2004;160:521–530
16
Coughlin SR et al. Obstructive sleep apnoea is independently associated with an increased prevalence of metabolic syndrome. European Heart J 2004;25:735-741.
17 Reichmuth
K et al. Association of sleep apnea and type II diabetes: a population-based study. Am J Respir Crit Care Med 2005;172(12):1590-5
18
Ip MS, et al. Obstructive sleep apnea is independently associated with insulin resistance. Am J Respir Crit Care Med 2002;165:670–676.
19
Punjabi NM, Sorkin JD, Katzel LI, Goldberg AP et al. Sleep-disordered breathing and insulin resistance in middle-aged and overweight men.Am J Respir Crit Care Med 2002; 165:677-682
20
Harsch I, Schahin S, et al. Continuous positive airway pressure treatment rapidly improves insulin sensitivity in patients with obstructive sleep apnea syndrome. Am J Respir Crit Care Med 2004;169(2):156-62.
21
Babu AR, Herdegen J, Fogelfeld L, Shott S et al. Type 2 diabetes, glycemic control and continuous positive airway pressure in obstructive sleep apnea. Archives of Internal Medicine 2005; 165:447-452
22
Becker HF, et al.. Effect of nasal continuous positive airway pressure treatment on blood pressure in patients with obstructive sleep apnea. Circulation 2003, 107:68-73