Sleep Apnea patients at increased risk of Diabetes, finds study

Brussels, Belgium: Overweight and obese patients with moderate and severe obstructive sleep apnea syndrome (OSAS) are more prone to suffer from glucose metabolism disorders, suggests a recent study published in the journal Sleep and Breathing. Based on the finding, the researchers stress that patients with moderate-to-severe OSAS should be screened for dysglycemia.

The study data revealed that in the population of overweight and obese patients with moderate and severe OSAS, 66% of patients had diabetes or glucose intolerance and 28% were newly diagnosed.

Overweight and obesity are major causal factors for obstructive sleep apnea syndrome, this explains why one-third of OSAS patients suffer from diabetes and another third from glucose intolerance. However, a significant proportion of the general population remains undiagnosed for glucose metabolism disorders. The study by Marie Bruyneel, Department of Pulmonary Medicine, CHU Saint-Pierre, Brussels, Belgium, and colleagues aimed to establish the prevalence of known and newly diagnosed glucose metabolism disorders in patients with moderate and severe OSAS referred to the sleep lab for continuous positive airway pressure (CPAP) therapy.

The researchers prospectively included 280 consecutive patients (70% men, mean ± SD body mass index 33 ± 7 kg/m², apnea-hypopnea index 49 ± 25) with moderate to severe OSAS referred for CPAP therapy. A fasting blood sample was collected to determine the glycosylated hemoglobin (HbA1c), glucose, and homeostatic model assessment (HOMA) index. Baseline demographic data and medication intake were recorded.

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Key findings of the study include:

• Of 280 consecutive patients, 22% exhibited diabetes and 44% glucose intolerance.


• Undiagnosed diabetes and glucose intolerance were found in 79 of 280 patients (28%).


• Insulin resistance was associated with OSAS severity in multivariate linear regression analysis.

"In this population of overweight and obese patients with moderate and severe OSAS, 66% of patients had diabetes or glucose intolerance and 28% were newly diagnosed," wrote the authors. "Diabetes and glucose intolerance were not related to OSAS severity, contrary to insulin resistance. These data suggest that there is value in systematic screening for glucose metabolism disorders in all patients with moderate and severe OSAS."

The study, "Prevalence of undiagnosed glucose intolerance and type 2 diabetes in patients with moderate-to-severe obstructive sleep apnea syndrome," is published in the journal Sleep and Breathing.

DOI: https://doi.org/10.1007/s11325-019-01989-y