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Cited by 295Obstructive Sleep Apnea ResearchSleep and related disordersNeuroscience of respiration and sleep

Obstructive sleep apnea in obese noninsulin-dependent diabetic patients: effect of continuous positive airway pressure treatment on insulin responsiveness

Brooks, B.·1994·Journal of Clinical Endocrinology & Metabolism
DOI 10.1210/jc.79.6.1681
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Abstract

Patients with noninsulin-dependent diabetes mellitus (NIDDM) are often obese and frequently complain of tiredness. These features are also characteristically seen in patients with obstructive sleep apnea (OSA). Therefore, it was the aim of this study to assess the prevalence of OSA among a group of obese NIDDM patients who have some clinical features of OSA. The effect of reversal of OSA by nasal continuous positive airway pressure (CPAP) treatment on insulin responsiveness was also investigated. From a population of 179 NIDDM patients with a body mass index (BMI) greater than 35 kg/m2, we performed ambulatory sleep monitoring on 31 (15 males and 16 females) who admitted to either heavy snoring or excessive sleepiness. Results were reviewed by a sleep physician blinded to the clinical status of the patients, and 22 (70%) were found to have moderate or severe OSA, with mean oxygen desaturation indexes of 10.3 +/- 5.3 and 30.7 +/- 13.2 episodes/h, respectively. A subgroup of 10 patients (seven males and three females) with a mean BMI of 42.7 +/- 4.3 kg/m2 was treated with nightly CPAP for 4 months. These subjects all had significant OSA, with frequent obstructive apneas (mean, 47 +/- 31.6 episodes/h) and oxygen desaturation (mean minimum O2 saturation, 74 +/- 9.5%), as determined by polysomnography. One patient was excluded from analysis because of infrequent use of CPAP. Insulin responsiveness in terms of glucose disposal measured by hyperinsulinemic euglycemic clamps improved from 11.4 +/- 6.2 to 15.1 +/- 4.6 mumol/kg.min (P < 0.05) during CPAP treatment. These results indicate that OSA occurs commonly in obese NIDDM patients with excessive sleepiness or heavy snoring. Treatment of their OSA may improve insulin responsiveness.

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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 [15]

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Authors
Brooks, B.
Affiliations
Royal Prince Alfred Hospital (AU)
Venue
Journal of Clinical Endocrinology & Metabolism
Publisher
The Endocrine Society
Published
1994-12-01
Volume
79
Issue
6
Pages
1681-1685
ISSN
0021-972X (ISSN-L)
DOI
10.1210/jc.79.6.1681
OpenAlex
W2009402354
Cited by
295
References
0
Citations by year
2025: 2 · 2024: 2 · 2023: 2 · 2021: 5 · 2020: 4 · 2019: 5 · 2018: 9 · 2017: 5 · 2016: 8 · 2015: 15 · 2014: 11 · 2013: 18 · 2012: 15
FWCI
0.45
Type
journal article
Language
en
Open access
closed
Locations
  • The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
  • Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Neuroscience of respiration and sleep
Keywords
obstructive sleep apnea, type 2 diabetes, obesity, continuous positive airway pressure, insulin sensitivity, glucose disposal, hyperinsulinemic-euglycemic clamp, excessive daytime sleepiness, snoring, oxygen desaturation, ambulatory sleep monitoring
MeSH terms
Adult, Blood Glucose, Diabetes Mellitus, Type 2, Female, Humans, Insulin, Male, Middle Aged, Obesity, Positive-Pressure Respiration, Sleep Apnea Syndromes, Body Mass Index, Diabetes Complications

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