Impact of Untreated Obstructive Sleep Apnea on Glucose Control in Type 2 Diabetes

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 patien...

Full description

Saved in:
Bibliographic Details
Published in:American journal of respiratory and critical care medicine 2010-03, Vol.181 (5), p.507-513
Main Authors: Aronsohn, Renee S, Whitmore, Harry, Van Cauter, Eve, Tasali, Esra
Format: Article
Language:English
Subjects:
Actigraphy
Adult
Aged
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Associated diseases and complications
Biological and medical sciences
Blood Glucose - metabolism
Body mass index
Cardiovascular disease
Comorbidity
Diabetes
Diabetes Mellitus, Type 2 - complications
Diabetes Mellitus, Type 2 - therapy
Diabetes. Impaired glucose tolerance
Endocrine pancreas. Apud cells (diseases)
Endocrinopathies
Eye movements
Female
Glucose
Glycated Hemoglobin - analysis
Hemoglobin
Humans
Hyperglycemia - complications
I. Sleep and Control of Ventilation
Intensive care medicine
Male
Medical sciences
Metabolism
Middle Aged
Obesity - complications
Patients
Polysomnography
Sleep apnea
Sleep Apnea, Obstructive - complications
Sleep disorders
Variables
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary: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. To determine the impact of OSA on hemoglobin A1c (HbA1c), the major clinical indicator of glycemic control, in patients with type 2 diabetes. We performed polysomnography studies and measured HbA1c in 60 consecutive patients with diabetes recruited from outpatient clinics between February 2007 and August 2009. A total of 77% of patients with diabetes had OSA (apnea-hypopnea index [AHI] > or =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. 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.
ISSN:1073-449X
1535-4970
DOI:10.1164/rccm.200909-1423OC