CPAP may improve glycemic control in sleep apnea patients

March 03, 2016

Continuous positive airway pressure, or CPAP, appears to improve glycemic control in patients with obstructive sleep apnea (OSA) and type 2 diabetes that is not well controlled, according to research published in the American Thoracic Society's American Journal of Respiratory and Critical Care Medicine. "Effect of CPAP on glycemic control in patients with obstructive sleep apnea and type 2 diabetes: A randomized clinical trial," is believed to be the first randomized controlled trial of its kind.

Francisco Garcia-Rio, MD, PhD, professor of medicine at Autonoma University of Madrid and senior study author, said the research advanced understanding of the biological relationship between two major public health problems, which epidemiological studies have indicated are related.

"OSA is a public health problem of the first order, due to its high prevalence and marked morbidity and mortality, having been linked to traffic accidents, cardiovascular complications and, more recently, neoplastic diseases," he said. "Diabetes mellitus is a global epidemic. There are currently 382 million diabetics worldwide, a figure which is estimated to reach 592 million in 2035."

Dr. Garcia-Rio and his colleagues studied results from 50 patients with both OSA and sub-optimally controlled type 2 diabetes, who were assigned to CPAP intervention or control. Participants, who ranged in age from 18 to 80, did not change diabetes medications during the trial unless medically necessary, nor were they expected to change their diets or level of physical activity.

In addition to measuring glucose control, researchers measured changes in insulin sensitivity and resistance, inflammatory proteins and other biomarkers that may be associated with type 2 diabetes glycemic control. Researchers found that those using CPAP showed a statistically significant:Researchers also found CPAP participants experienced lower levels of the inflammatory molecules IL-1β and IL-6 and higher levels of the hormone adiponectin, an important glucose regulator.

Authors noted that previous studies reported a 1 percent decrease in HbA1c levels was associated with 15-20 percent decrease in major cardiovascular disease events and a 37 percent decrease in microvascular complications from diabetes. If the association proves true, the authors said the 0.4 percent reduction in HbA1c in their study might translate into a 6-8 percent decrease in cardiovascular disease risk and a 15 percent reduction in microvascular complication risk. They added that their study also found those in the CPAP group experienced a significant reduction in LDL cholesterol, an established risk factor for cardiovascular disease.

Dr. Garcia-Rio said study findings suggest that "early identification of OSA in patients with type 2 diabetes, and assessment for metabolic abnormalities in those with OSA could reduce the cardiovascular disease risk of patients with these chronic diseases."

Researchers believe results are generalizable, given that patients included in the study were referred from diabetes units or primary care physicians, reflecting standard clinical practice. Study limitations include small sample size, lack of a placebo arm and medication changes that were necessary for some patients during the trial.
-end-
The Instituto de Salud Carlos III and the Comunidad de Madrid funded this study.

Contact for article: Francisco Garcia-Rio, MD, PhD
Email: fgr01@gmail.com

American Thoracic Society

Related Diabetes Articles from Brightsurf:

New diabetes medication reduced heart event risk in those with diabetes and kidney disease
Sotagliflozin - a type of medication known as an SGLT2 inhibitor primarily prescribed for Type 2 diabetes - reduces the risk of adverse cardiovascular events for patients with diabetes and kidney disease.

Diabetes drug boosts survival in patients with type 2 diabetes and COVID-19 pneumonia
Sitagliptin, a drug to lower blood sugar in type 2 diabetes, also improves survival in diabetic patients hospitalized with COVID-19, suggests a multicenter observational study in Italy.

Making sense of diabetes
Throughout her 38-year nursing career, Laurel Despins has progressed from a bedside nurse to a clinical nurse specialist and has worked in medical, surgical and cardiac intensive care units.

Helping teens with type 1 diabetes improve diabetes control with MyDiaText
Adolescence is a difficult period of development, made more complex for those with Type 1 diabetes mellitus (T1DM).

Diabetes-in-a-dish model uncovers new insights into the cause of type 2 diabetes
Researchers have developed a novel 'disease-in-a-dish' model to study the basic molecular factors that lead to the development of type 2 diabetes, uncovering the potential existence of major signaling defects both inside and outside of the classical insulin signaling cascade, and providing new perspectives on the mechanisms behind insulin resistance in type 2 diabetes and possibly opportunities for the development of novel therapeutics for the disease.

Tele-diabetes to manage new-onset diabetes during COVID-19 pandemic
Two new case studies highlight the use of tele-diabetes to manage new-onset type 1 diabetes in an adult and an infant during the COVID-19 pandemic.

Genetic profile may predict type 2 diabetes risk among women with gestational diabetes
Women who go on to develop type 2 diabetes after having gestational, or pregnancy-related, diabetes are more likely to have particular genetic profiles, suggests an analysis by researchers at the National Institutes of Health and other institutions.

Maternal gestational diabetes linked to diabetes in children
Children and youth of mothers who had gestational diabetes during pregnancy are at increased risk of diabetes themselves, according to new research published in CMAJ (Canadian Medical Association Journal).

Two diabetes medications don't slow progression of type 2 diabetes in youth
In youth with impaired glucose tolerance or recent-onset type 2 diabetes, neither initial treatment with long-acting insulin followed by the drug metformin, nor metformin alone preserved the body's ability to make insulin, according to results published online June 25 in Diabetes Care.

People with diabetes visit the dentist less frequently despite link between diabetes, oral health
Adults with diabetes are less likely to visit the dentist than people with prediabetes or without diabetes, finds a new study led by researchers at NYU Rory Meyers College of Nursing and East Carolina University's Brody School of Medicine.

Read More: Diabetes News and Diabetes Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.