Effect of Continuous Positive Airway Pressure Therapy on Glycemic Excursions and Insulin Sensitivity in Patients with Obstructive Sleep Apnea-hypopnea Syndrome and Type 2 Diabetes

• Published in: Chinese medical journal Vol. 128; no. 17; pp. 2301 - 2306
• Main Authors: Guo, Li-Xin, Zhao, Xin, Pan, Qi, Sun, Xue, Li, Hui, Wang, Xiao-Xia, Zhang, Li-Na, Wang, Yao
• Format: Journal Article
• Language: English
• Published: China Medknow Publications Pvt Ltd 05.09.2015; Medknow Publications and Media Pvt. Ltd; Lippincott Williams & Wilkins Ovid Technologies; Department of Endocrinology, Beijing Hospital, Beijing 100730, China%Department of General Medicine, First Hospital of China Medical University, Shenyang, Liaoning 110001, China; Medknow Publications & Media Pvt Ltd; Wolters Kluwer
• Subjects: 2型糖尿病; Adult; Blood Glucose - physiology; Body mass index; Care and treatment; Clinical trials; Continuous positive airway pressure; Continuous Positive Airway Pressure - methods; Diabetes; Diabetes Mellitus, Type 2 - therapy; Endocrinology; Female; Glucose; Hospitals; Humans; Hypoxia; Insulin resistance; Insulin Resistance - physiology; Male; Metabolism; Methods; Middle Aged; Monitoring systems; Original; Patient outcomes; Sleep; Sleep apnea; Sleep Apnea, Obstructive - therapy; Studies; Treatment Outcome; Type 2 diabetes; 患者; 正压通气; 睡眠呼吸暂停; 综合征; 胰岛素敏感性; 血糖水平; 阻塞; Continuous Positive Airway Pressure; Continuous Glucose Monitoring System; Type 2 Diabetes Mellitus; Obstructive Sleep Apnea-hypopnea Syndrome
• ISSN: 0366-6999; 2542-5641
• DOI: 10.4103/0366-6999.163382

Background： For patients with obstructive sleep apnea-hypopnea syndrome （OSAHS） and type 2 diabetes mellitus （T2DM）, the night sleep interruption and intermittent hypoxia due to apnea or hypopnea may induce glycemic excursions and reduce insulin sensitivity. This study aimed to investigate the effect of continuous positive airway pressure （CPAP） therapy in patients with OSAHS and T2DM. Methods： Continuous glucose monitoring system （CGMS） was used in 40 patients with T2DM and newly diagnosed OSAHS. The measurements were repeated after 30 days of CPAP treatment. Subsequently, insulin sensitivity and glycohemoglobin （HbAlc） were measured and compared to the pretreatment data. Results： After CPAP therapy, the CGMS indicators showed that the 24-h mean blood glucose （MBG） and the night time MBG were significantly reduced （P 〈 0.05 and P = 0.03, respectively）. The mean ambulatory glucose excursions （MAGEs） and the mean of daily differences were also significantly reduced （P 〈 0.05 and P = 0.002, respectively） compared to pretreatment levels. During the night, MAGE also significantly decreased （P = 0.049）. The differences between the highest and lowest levels of blood glucose over 24 h and during the night were significantly lower than prior to CPAP treatment （P 〈 0.05 and P = 0.024, respectively）. The 24 h and night time durations of high blood glucose （〉7.8 mmol/L and 〉 11.1 mmol/L） decreased （P 〈 0.05 and P 〈 0.05, respectively） after the treatment. In addition, HbA 1 c levels were also lower than those before treatment （P 〈 0.05）, and the homeostasis model assessment index of insulin resistance was also significantly lower than before CPAP treatment （P = 0.034）. Conclusions： CPAP therapy may have a beneficial effect on improving not only blood glucose but also upon insulin sensitivity in T2DM patients with OSAHS. This suggests that CPAP may be an effective treatment for T2DM in addition to intensive diabetes management.