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Type 2 Diabetes, Glycemic Control, and Continuous Positive Airway Pressure in Obstructive Sleep Apnea
Abstract
BACKGROUND: Sleep-disordered breathing (SDB) is a prevalent condition associated with significant comorbidities, including hypertension, obesity, cardiovascular disease, and insulin resistance. It has been previously shown that the severity of insulin resistance is related to the severity of SDB. METHODS: Using a 72-hour continuous glucose monitoring system, we studied changes in interstitial glucose levels and measured hemoglobin A1c levels in 25 patients with type 2 diabetes mellitus before and after continuous positive airway pressure (CPAP) treatment for SDB. RESULTS: With a mean +/- SD CPAP treatment period of 83 +/- 50 days, the mean +/- SD 1-hour postprandial glucose values were significantly reduced for breakfast (191 +/- 68 mg/dL to 130 +/- 41 mg/dL [10.6 +/- 3.8 mmol/L to 7.2 +/- 2.3 mmol/L]), lunch (196 +/- 70 mg/dL to 138 +/- 49 mg/dL [10.9 +/- 3.9 mmol/L to 7.7 +/- 2.7 mmol/L]), and dinner (199 +/- 66 mg/dL to 137 +/- 48 mg/dL [11.0 +/- 3.7 mmol/L to 7.6 +/- 2.7 mmol/L]). In the 17 patients with a baseline hemoglobin A1c level greater than 7%, there was a significant reduction in hemoglobin A1c level (9.2% +/- 2.0% to 8.6% +/- 1.8%). Furthermore, in subjects who used CPAP for more than 4 h/d, the reduction in hemoglobin A1c level was significantly correlated with days of CPAP use. There was no such correlation in subjects who used CPAP for 4 h/d or less. CONCLUSIONS: These findings suggest that SDB is pathophysiologically related to impaired glucose homeostasis, and that CPAP can be an important therapeutic approach for diabetic patients with SDB.
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In the citing paper
“OBSTRUCTIVE SLEEP APNEA (OSA) IS A HIGHLY PREV-ALENT SYNDROME THAT IS ASSOCIATED WITH SUB-STANTIAL MORBIDITY AND INCREASED MORTALITY. 1-10”
In the citing paper
“Positive airway pressure (PAP) is the most uniformly effective therapy, and to date this is the only intervention for OSA shown to have a favorable impact on both cardiovascular and neurobehavioral morbidities.1,2,6”
In the citing paper
“Methodological differences may also account for the variability of results obtained: four positive studies relied on the hyperinsulinemic–euglycemic clamp technique to assess SI [15, 65, 66, 142], which is considered the gold standard to evaluate SI; another two used continuous glucose monitoring (CGMS) [4, 205], which provides 288 readings of interstitial glucose levels per 24 h (every 5 min) and”
From Sleep and metabolic function (2012) · cites this paper as [4]
In the citing paper
“Improvement in glycemic control has been demonstrated after 3 months of CPAP use, with improvement related to number of hours of nightly CPAP use(107, 108).”
From Sleep: important considerations for the prevention of cardiovascular disease (2016) · cites this paper as [108]
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ResultInfluentialTreatment of obstructive sleep apnoea.
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Metadata
- Authors
- Babu, A. R., Herdegen, J., Fogelfeld, L., Shott, S., & Mazzone, T.
- Affiliations
- Rush University Medical Center (US)
- ORCID
- Fogelfeld, Leon
- Venue
- Archives of Internal Medicine
- Publisher
- American Medical Association (AMA)
- Published
- 2005-02-28
- Volume
- 165
- Issue
- 4
- Pages
- 447
- ISSN
- 0003-9926 (ISSN-L)
- OpenAlex
- W2103628919
- Cited by
- 453
- References
- 41
- Citations by year
- 2026: 2 · 2025: 12 · 2024: 4 · 2023: 7 · 2022: 13 · 2021: 7 · 2020: 15 · 2019: 12 · 2018: 18 · 2017: 16 · 2016: 21 · 2015: 33 · 2014: 31 · 2013: 22 · 2012: 37
- FWCI
- 21.57
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology (medical) › Obstructive Sleep Apnea Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- type 2 diabetes, obstructive sleep apnea, sleep-disordered breathing, continuous positive airway pressure, glycemic control, HbA1c, postprandial blood glucose, insulin resistance, glucose homeostasis
- MeSH terms
- Adult, Blood Glucose, Circadian Rhythm, Diabetes Mellitus, Type 2, Female, Glycated Hemoglobin, Humans, Insulin Resistance, Male, Middle Aged, Obesity, Prospective Studies, Surveys and Questionnaires, Polysomnography, Sleep Apnea, Obstructive, Glycemic Index, Continuous Positive Airway Pressure
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