Effect of continuous positive airway pressure on glucose metabolism in adults with type 2 diabetes: a systematic review and meta-analysis of randomized controlled trials
Obstructive sleep apnea (OSA) has many serious consequences, and one of these may be the exacerbation of type 2 diabetes mellitus (T2DM). Reports on the effect of continuous positive airway pressure (CPAP) on glucose metabolism in people with T2DM and OSA are conflicting. Therefore, the purpose of t...
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| description | Obstructive sleep apnea (OSA) has many serious consequences, and one of these may be the exacerbation of type 2 diabetes mellitus (T2DM). Reports on the effect of continuous positive airway pressure (CPAP) on glucose metabolism in people with T2DM and OSA are conflicting. Therefore, the purpose of this review was to examine the effect of CPAP treatment on glucose metabolism by synthesizing findings from randomized controlled trials. The PRISMA review protocol was developed and registered in PROSPERO. A systematic search of PubMed, CINAHL, Embase, Web of Science, PsycInfo, and Cochrane was conducted from inception to March 2017. The Cochrane risk of bias tool was used to assess the study quality. Review Manager (v5.2) was used for the meta-analyses, and the standardized mean difference was calculated. Six studies consisting of 496 participants were included in this review. The meta-analyses indicated that CPAP treatment did not have significant impact on glucose metabolism measured by A1C (mean difference = 0.05, 95% CI − 0.14 to 0.24,
P
= 0.61), fasting insulin level (mean difference = − 2.34, 95% CI − 8.19 to 3.51,
P
= 0.43), and fasting glucose (mean difference = − 0.05, 95% CI − 0.52 to 0.42,
P
= 0.84). As expected, CPAP treatment can improve daytime sleepiness (mean difference = − 2.68, 95% CI − 3.91 to − 1.54,
P
|
| doi_str_mv | 10.1007/s11325-017-1554-x |
| format | Article |
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P
= 0.61), fasting insulin level (mean difference = − 2.34, 95% CI − 8.19 to 3.51,
P
= 0.43), and fasting glucose (mean difference = − 0.05, 95% CI − 0.52 to 0.42,
P
= 0.84). As expected, CPAP treatment can improve daytime sleepiness (mean difference = − 2.68, 95% CI − 3.91 to − 1.54,
P
< 0.001). Findings of this meta-analysis do not substantiate a positive effect of CPAP on glucose metabolism in people with T2DM and coexisting OSA. Future large-scale clinical trials with a longer treatment duration and better CPAP compliance are warranted.</description><identifier>ISSN: 1520-9512</identifier><identifier>EISSN: 1522-1709</identifier><identifier>DOI: 10.1007/s11325-017-1554-x</identifier><identifier>PMID: 28812180</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Apnea ; Clinical trials ; Continuous Positive Airway Pressure ; Dentistry ; Diabetes ; Diabetes mellitus ; Diabetes mellitus (non-insulin dependent) ; Diabetes Mellitus, Type 2 - complications ; Diabetes Mellitus, Type 2 - metabolism ; Fasting ; Glucose ; Glucose - metabolism ; Humans ; Insulin ; Internal Medicine ; Laboratory testing ; Medicine ; Medicine & Public Health ; Meta-analysis ; Metabolism ; Neurology ; Otorhinolaryngology ; Pediatrics ; Pneumology/Respiratory System ; Pressure ; Randomized Controlled Trials as Topic ; Respiratory tract ; Reviews ; Sleep ; Sleep and wakefulness ; Sleep Apnea, Obstructive - complications ; Sleep Apnea, Obstructive - metabolism ; Sleep Apnea, Obstructive - therapy ; Sleep Breathing Physiology and Disorders • Review ; Sleep disorders ; Systematic review</subject><ispartof>Sleep & breathing, 2018-05, Vol.22 (2), p.287-295</ispartof><rights>Springer International Publishing AG 2017</rights><rights>Sleep and Breathing is a copyright of Springer, (2017). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-43086cc79a8ae086c39561b481296a901d1c07dc8d42c00e263efb2a8bd565543</citedby><cites>FETCH-LOGICAL-c372t-43086cc79a8ae086c39561b481296a901d1c07dc8d42c00e263efb2a8bd565543</cites><orcidid>0000-0003-3997-7882</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11325-017-1554-x$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11325-017-1554-x$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28812180$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zhu, Bingqian</creatorcontrib><creatorcontrib>Ma, Chao</creatorcontrib><creatorcontrib>Chaiard, Jindarat</creatorcontrib><creatorcontrib>Shi, Changgui</creatorcontrib><title>Effect of continuous positive airway pressure on glucose metabolism in adults with type 2 diabetes: a systematic review and meta-analysis of randomized controlled trials</title><title>Sleep & breathing</title><addtitle>Sleep Breath</addtitle><addtitle>Sleep Breath</addtitle><description>Obstructive sleep apnea (OSA) has many serious consequences, and one of these may be the exacerbation of type 2 diabetes mellitus (T2DM). Reports on the effect of continuous positive airway pressure (CPAP) on glucose metabolism in people with T2DM and OSA are conflicting. Therefore, the purpose of this review was to examine the effect of CPAP treatment on glucose metabolism by synthesizing findings from randomized controlled trials. The PRISMA review protocol was developed and registered in PROSPERO. A systematic search of PubMed, CINAHL, Embase, Web of Science, PsycInfo, and Cochrane was conducted from inception to March 2017. The Cochrane risk of bias tool was used to assess the study quality. Review Manager (v5.2) was used for the meta-analyses, and the standardized mean difference was calculated. Six studies consisting of 496 participants were included in this review. The meta-analyses indicated that CPAP treatment did not have significant impact on glucose metabolism measured by A1C (mean difference = 0.05, 95% CI − 0.14 to 0.24,
P
= 0.61), fasting insulin level (mean difference = − 2.34, 95% CI − 8.19 to 3.51,
P
= 0.43), and fasting glucose (mean difference = − 0.05, 95% CI − 0.52 to 0.42,
P
= 0.84). As expected, CPAP treatment can improve daytime sleepiness (mean difference = − 2.68, 95% CI − 3.91 to − 1.54,
P
< 0.001). Findings of this meta-analysis do not substantiate a positive effect of CPAP on glucose metabolism in people with T2DM and coexisting OSA. Future large-scale clinical trials with a longer treatment duration and better CPAP compliance are warranted.</description><subject>Apnea</subject><subject>Clinical trials</subject><subject>Continuous Positive Airway Pressure</subject><subject>Dentistry</subject><subject>Diabetes</subject><subject>Diabetes mellitus</subject><subject>Diabetes mellitus (non-insulin dependent)</subject><subject>Diabetes Mellitus, Type 2 - complications</subject><subject>Diabetes Mellitus, Type 2 - metabolism</subject><subject>Fasting</subject><subject>Glucose</subject><subject>Glucose - metabolism</subject><subject>Humans</subject><subject>Insulin</subject><subject>Internal Medicine</subject><subject>Laboratory testing</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Meta-analysis</subject><subject>Metabolism</subject><subject>Neurology</subject><subject>Otorhinolaryngology</subject><subject>Pediatrics</subject><subject>Pneumology/Respiratory System</subject><subject>Pressure</subject><subject>Randomized Controlled Trials as Topic</subject><subject>Respiratory tract</subject><subject>Reviews</subject><subject>Sleep</subject><subject>Sleep and wakefulness</subject><subject>Sleep Apnea, Obstructive - complications</subject><subject>Sleep Apnea, Obstructive - metabolism</subject><subject>Sleep Apnea, Obstructive - therapy</subject><subject>Sleep Breathing Physiology and Disorders • Review</subject><subject>Sleep disorders</subject><subject>Systematic review</subject><issn>1520-9512</issn><issn>1522-1709</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp1kctu1TAQhiMEoqXwAGyQJTZsDB7n4pgdqtqCVIkNrC3HmRRXSRw8Tk_DG_GW-JxTQEJiNSP7m38uf1G8BPEWhFDvCKCUNRegONR1xe8fFadQS8lBCf34kAuua5AnxTOiWyGgajU8LU5k24KEVpwWPy-GAV1iYWAuzMnPa1iJLYF88nfIrI87u7ElItEakYWZ3YyrC4RswmS7MHqamJ-Z7dcxEdv59I2lbUEmWe9thwnpPbOMNko42eQdi3jnccfs3B8kuJ3tuJGn_Qgxv4bJ_8D-ME0M45jTFL0d6XnxZMgBXzzEs-Lr5cWX84_8-vPVp_MP19yVSiZelaJtnFPathb3aanrBroqL6wbqwX04ITqXdtX0gmBsilx6KRtu75u8hHLs-LNUXeJ4fuKlMzkyeE42hnzbQxoqVutoKwz-vof9DasMe9DRopSNKDUgYIj5WIgijiYJfrJxs2AMHsfzdFHk300ex_Nfa559aC8dhP2fyp-G5cBeQQof803GP-2_r_qLwnKq9c</recordid><startdate>20180501</startdate><enddate>20180501</enddate><creator>Zhu, Bingqian</creator><creator>Ma, Chao</creator><creator>Chaiard, Jindarat</creator><creator>Shi, Changgui</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0-V</scope><scope>3V.</scope><scope>7T5</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>88J</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ALSLI</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>M2R</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-3997-7882</orcidid></search><sort><creationdate>20180501</creationdate><title>Effect of continuous positive airway pressure on glucose metabolism in adults with type 2 diabetes: a systematic review and meta-analysis of randomized controlled trials</title><author>Zhu, Bingqian ; Ma, Chao ; Chaiard, Jindarat ; Shi, Changgui</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-43086cc79a8ae086c39561b481296a901d1c07dc8d42c00e263efb2a8bd565543</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Apnea</topic><topic>Clinical trials</topic><topic>Continuous Positive Airway Pressure</topic><topic>Dentistry</topic><topic>Diabetes</topic><topic>Diabetes mellitus</topic><topic>Diabetes mellitus (non-insulin dependent)</topic><topic>Diabetes Mellitus, Type 2 - complications</topic><topic>Diabetes Mellitus, Type 2 - metabolism</topic><topic>Fasting</topic><topic>Glucose</topic><topic>Glucose - metabolism</topic><topic>Humans</topic><topic>Insulin</topic><topic>Internal Medicine</topic><topic>Laboratory testing</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Meta-analysis</topic><topic>Metabolism</topic><topic>Neurology</topic><topic>Otorhinolaryngology</topic><topic>Pediatrics</topic><topic>Pneumology/Respiratory System</topic><topic>Pressure</topic><topic>Randomized Controlled Trials as Topic</topic><topic>Respiratory tract</topic><topic>Reviews</topic><topic>Sleep</topic><topic>Sleep and wakefulness</topic><topic>Sleep Apnea, Obstructive - complications</topic><topic>Sleep Apnea, Obstructive - metabolism</topic><topic>Sleep Apnea, Obstructive - therapy</topic><topic>Sleep Breathing Physiology and Disorders • Review</topic><topic>Sleep disorders</topic><topic>Systematic review</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zhu, Bingqian</creatorcontrib><creatorcontrib>Ma, Chao</creatorcontrib><creatorcontrib>Chaiard, Jindarat</creatorcontrib><creatorcontrib>Shi, Changgui</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Social Sciences Premium Collection</collection><collection>ProQuest Central (Corporate)</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Social Science Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Social Science Premium Collection</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Psychology Database</collection><collection>Social Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Sleep & breathing</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zhu, Bingqian</au><au>Ma, Chao</au><au>Chaiard, Jindarat</au><au>Shi, Changgui</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effect of continuous positive airway pressure on glucose metabolism in adults with type 2 diabetes: a systematic review and meta-analysis of randomized controlled trials</atitle><jtitle>Sleep & breathing</jtitle><stitle>Sleep Breath</stitle><addtitle>Sleep Breath</addtitle><date>2018-05-01</date><risdate>2018</risdate><volume>22</volume><issue>2</issue><spage>287</spage><epage>295</epage><pages>287-295</pages><issn>1520-9512</issn><eissn>1522-1709</eissn><abstract>Obstructive sleep apnea (OSA) has many serious consequences, and one of these may be the exacerbation of type 2 diabetes mellitus (T2DM). Reports on the effect of continuous positive airway pressure (CPAP) on glucose metabolism in people with T2DM and OSA are conflicting. Therefore, the purpose of this review was to examine the effect of CPAP treatment on glucose metabolism by synthesizing findings from randomized controlled trials. The PRISMA review protocol was developed and registered in PROSPERO. A systematic search of PubMed, CINAHL, Embase, Web of Science, PsycInfo, and Cochrane was conducted from inception to March 2017. The Cochrane risk of bias tool was used to assess the study quality. Review Manager (v5.2) was used for the meta-analyses, and the standardized mean difference was calculated. Six studies consisting of 496 participants were included in this review. The meta-analyses indicated that CPAP treatment did not have significant impact on glucose metabolism measured by A1C (mean difference = 0.05, 95% CI − 0.14 to 0.24,
P
= 0.61), fasting insulin level (mean difference = − 2.34, 95% CI − 8.19 to 3.51,
P
= 0.43), and fasting glucose (mean difference = − 0.05, 95% CI − 0.52 to 0.42,
P
= 0.84). As expected, CPAP treatment can improve daytime sleepiness (mean difference = − 2.68, 95% CI − 3.91 to − 1.54,
P
< 0.001). Findings of this meta-analysis do not substantiate a positive effect of CPAP on glucose metabolism in people with T2DM and coexisting OSA. Future large-scale clinical trials with a longer treatment duration and better CPAP compliance are warranted.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>28812180</pmid><doi>10.1007/s11325-017-1554-x</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0003-3997-7882</orcidid></addata></record> |
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| subjects | Apnea Clinical trials Continuous Positive Airway Pressure Dentistry Diabetes Diabetes mellitus Diabetes mellitus (non-insulin dependent) Diabetes Mellitus, Type 2 - complications Diabetes Mellitus, Type 2 - metabolism Fasting Glucose Glucose - metabolism Humans Insulin Internal Medicine Laboratory testing Medicine Medicine & Public Health Meta-analysis Metabolism Neurology Otorhinolaryngology Pediatrics Pneumology/Respiratory System Pressure Randomized Controlled Trials as Topic Respiratory tract Reviews Sleep Sleep and wakefulness Sleep Apnea, Obstructive - complications Sleep Apnea, Obstructive - metabolism Sleep Apnea, Obstructive - therapy Sleep Breathing Physiology and Disorders • Review Sleep disorders Systematic review |
| title | Effect of continuous positive airway pressure on glucose metabolism in adults with type 2 diabetes: a systematic review and meta-analysis of randomized controlled trials |
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