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| |  Obstructive Sleep Apnoea May Worsen Diabetes NEW YORK -- January 14, 2010 -- Obstructive Sleep Apnoea (OSA) adversely affects glucose control in patients with type 2 diabetes, according to a study published early online and appearing in an upcoming edition of the Journal of Respiratory and Critical Care Medicine. The study “demonstrates for the first time that there is a clear, graded, inverse relationship between OSA severity and glucose control in patients with type 2 diabetes,” said lead author, Renee S. Aronsohn, MD, University of Chicago, Chicago, Illinois. The study also confirmed other reports that undiagnosed OSA is very common among patients with type 2 diabetes, indicating that it is largely unrecognised additional medical risk factor in these patients. Dr. Aronsohn and colleagues consecutively recruited patients with type 2 diabetes from outpatient clinics to participate in the study. The participants were interviewed to assess their diabetes history, medical history and medications, and level of physical activity. Height and weight measurements were taken, and each participant’s sleep/wake cycles were monitored for 5 days using wrist actigraphy and self-reported sleep logs. Patients underwent an overnight polysomnography test for OSA, and glucose control was assessed by obtaining a blood sample for haemoglobin A1c (HbA1c) measurement. In total, 60 patients were included in the study’s final analysis. More than three-quarters (77%) of participants had OSA, but only 5 had been previously evaluated for the disease, and none were undergoing treatment. Of the study sample, 38% (23) were classified as having mild OSA, 25% (15) had moderate OSA, and 13% (8) had severe OSA. The researchers found that more severe OSA was associated with poorer glucose control, implying a role more severe diabetes with potentially more complications. Relative to patients without OSA, the presence of mild, moderate or severe OSA significantly increased mean adjusted HbA1c values by 1.49%, 1.93%, and 3.69%, respectively. These effect sizes are comparable with those of widely used hypoglycaemic medications, meaning that having OSA may negate the beneficial effects of anti-diabetic drugs. “Our findings have important clinical implications as they support the hypothesis that reducing the severity of OSA may improve glycaemia control,” said Dr. Aronsohn. “Thus effective treatment of OSA may represent a novel and non-pharmacologic intervention in the management of type 2 diabetes.” SOURCE: American Thoracic Society
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