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Cited by 219Obstructive Sleep Apnea ResearchSleep and related disordersDiabetes, Cardiovascular Risks, and Lipoproteins

The Effect of Continuous Positive Airway Pressure Treatment on Insulin Sensitivity in Patients with Obstructive Sleep Apnoea Syndrome and Type 2 Diabetes

Harsch, Igor Alexander, Schahin, Simin Pour, Brückner, Kerstin, Radespiel-Tröger, Martin, Fuchs, Florian S., Hahn, Eckhart Georg, Konturek, Peter Christopher, Lohmann, Tobias +1 more·2004·Respiration
DOI 10.1159/000077423
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Abstract

Background: The obstructive sleep apnoea syndrome (OSA) is a frequent condition, as well as type 2 diabetes mellitus. Both diseases are characterized by insulin resistance. Objectives: The aim of this study was to establish whether OSA is an independent risk factor for increased insulin resistance in diabetics. For this purpose, we tested the hypothesis that the insulin sensitivity in patients with type 2 diabetes and OSA can be improved by 2 days or 3 months of continuous positive airway pressure (CPAP) treatment. Methods: In 9 obese patients with type 2 diabetes and OSA [apnoea/hypopnoea index 43.1 ± 21.3; body mass index (BMI) 37.3 ± 5.6 kg/m 2] and good glycaemic control on oral antidiabetics or on diet alone (HbA1c 6.4 ± 0.7%), the insulin sensitivity index (ISI) was established by euglycaemic hyperinsulinaemic clamp tests at baseline, after 2 days and after 3 months of effective CPAP treatment. Results: ISI was unchanged after 2 days of CPAP treatment, but was significantly improved after 3 months (4.38 ± 2.94 vs. 2.74 ± 2.25 at baseline; p = 0.021), without any significant changes in BMI. Glycaemic control was unaffected after 3 months (HbA1c 6.3 ± 0.6%; not significant). Fasting leptin levels showed no significant changes. Conclusions: These results indicate that OSA itself is an independent risk factor for insulin resistance. This effect may be explained by the elevated sympathetic activity in OSA.

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Crossref · 10.1159/000077423

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  • Four positive studies used the hyperinsulinemic-euglycemic clamp, two used continuous glucose monitoring, and one used the minimal model estimate from an intravenous glucose tolerance test.

    “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 [66]

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Authors
Harsch, I. A., Schahin, S. P., Brückner, K., Radespiel-Tröger, M., Fuchs, F. S., Hahn, E. G., Konturek, P. C., Lohmann, T., & Ficker, J. H.
Affiliations
Friedrich-Alexander-Universität Erlangen-Nürnberg (DE)
ORCID
Venue
Respiration
Publisher
S. Karger AG
Published
2004
Volume
71
Issue
3
Pages
252-259
ISSN
  • 0025-7931 (ISSN-L)
  • 1423-0356
DOI
10.1159/000077423
OpenAlex
W2043246888
Cited by
219
References
46
Citations by year
2025: 4 · 2024: 2 · 2023: 1 · 2022: 2 · 2021: 4 · 2020: 5 · 2019: 4 · 2018: 9 · 2017: 8 · 2016: 17 · 2015: 18 · 2014: 15 · 2013: 7 · 2012: 17
FWCI
7.61
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Respiration (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • B. Braun-Stiftung
  • Karl-Franzens-Universität Graz
Topics
  • Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Keywords
obstructive sleep apnea, type 2 diabetes, insulin resistance, continuous positive airway pressure, CPAP therapy, insulin sensitivity, hyperinsulinemic-euglycemic clamp, leptin, obesity, sympathetic activity, glycemic control
MeSH terms
Diabetes Mellitus, Type 2, Female, Humans, Insulin Resistance, Male, Middle Aged, Risk Factors, Treatment Outcome, Sleep Apnea, Obstructive, Continuous Positive Airway Pressure

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