Treatment Effects of Short-Term Continuous Positive Airway Pressure on Blood Glucose Control in Type 2 Diabetic Patients with Obstructive Sleep Apnea Syndrome
Purpose: The study aimed at assessing glucose control measured with a continuous glucose monitoring system (CGMS) before and after short-term continuous positive airway pressure (CPAP). Materials and Methods: Twenty-four type 2 diabetic patients (T2DM) with Obstructive sleep apnea syndrome (OSAS) (m...
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Veröffentlicht in: | International journal of general medicine 2020-01, Vol.13, p.1567-1573 |
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Zusammenfassung: | Purpose: The study aimed at assessing glucose control measured with a continuous glucose monitoring system (CGMS) before and after short-term continuous positive airway pressure (CPAP).
Materials and Methods: Twenty-four type 2 diabetic patients (T2DM) with Obstructive sleep apnea syndrome (OSAS) (mean age 55.0 +/- 9.0 years; BMI 29.5 +/- 5.2 kg/m(2)) were admitted and kept under diet control for 2 days, then underwent 2 overnight polysomnographics: a diagnostic study and one with CPAP titration. Then they were treated by CPAP during sleep for the following three nights. Participants were divided into subgroup D (only diet control) and subgroup M (with DM medication). CGMS was utilized over the last five days. Glucose control was also assessed with plasma insulin and a clinical measure of insulin resistance (HOMA-IR) index.
Results: The mean (+/- SD) apnea-hypopnea index (AHI) at diagnostic polysomnography was 51.2 +/- 22.4 (range 10-88) events/h. CPAP treatment in the subjects with OSAS resulted in the index of oxygenation desaturations being reduced from 33.3 +/- 20.1 to 1.1 +/- 1.6 (P =0.00). CGMS showed mean 24-hours glucose values significantly lower after CPAP treatment than at baseline in both subgroups (7.97 +/- 1.31 vs 7.52 +/- 0.94, P=0.033 in subgroup D; and 7.72 +/- 1.51 vs 7.17 +/- 1.21, P=0.05 in subgroup M), as the fasting plasma insulin levels and HOMA-IR were also decreased significantly after CPAP treatment (13.0 +/- 7.5 mu U/mL vs 10.8 +/- 5.4 mu U/mL, P=0.044; and 4.2 +/- 2.2 vs 3.1 +/- 1.7, P=0.003, respectively) Standard deviation (SD) and mean amplitude of glucose excursions (MAGE) were also decreased in the subgroup D (1.91 +/- 1.10 vs 1.61 +/- 1.20, P=0.014; 1.26 +/- 1.13 vs 1.01 +/- 0.98, P=0.008, respectively) only.
Conclusion: Short-term CPAP treatment in OSAS with type 2 diabetic patients is accompanied by a decrease in blood glucose level and improved insulin sensitivity. Glucose variability was reduced but only in the patients with diet control. |
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ISSN: | 1178-7074 1178-7074 |
DOI: | 10.2147/IJGM.S280837 |