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Association between obstructive sleep apnea severity and glucose control in patients with untreated versus treated diabetes
Author(s) -
Priou Pascaline,
Le Vaillant Marc,
Meslier Nicole,
Chollet Sylvaine,
Pigeanne Thierry,
Masson Philippe,
BizieuxThaminy Acya,
Humeau MariePierre,
Goupil François,
Ducluzeau PierreHenri,
Gagnadoux Frédéric
Publication year - 2015
Publication title -
journal of sleep research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.297
H-Index - 117
eISSN - 1365-2869
pISSN - 0962-1105
DOI - 10.1111/jsr.12278
Subject(s) - medicine , diabetes mellitus , obstructive sleep apnea , body mass index , quartile , sleep apnea , apnea–hypopnea index , type 2 diabetes , apnea , endocrinology , polysomnography , confidence interval
Summary The purpose of this study was to determine whether the association between obstructive sleep apnea severity and glucose control differs between patients with newly diagnosed and untreated type 2 diabetes, and patients with known and treated type 2 diabetes. This multicentre cross‐sectional study included 762 patients investigated by sleep recording for suspected obstructive sleep apnea, 497 of whom were previously diagnosed and treated for type 2 diabetes (treated diabetic patients), while 265 had no medical history of diabetes but had fasting blood glucose ≥126 mg dL −1 and/or glycated haemoglobin (HbA 1c ) ≥6.5% consistent with newly diagnosed type 2 diabetes (untreated diabetic patients). Multivariate regression analyses were performed to evaluate the independent association between HbA 1c and obstructive sleep apnea severity in treated and untreated patients with diabetes. In untreated diabetic patients, HbA 1c was positively associated with apnea–hypopnea index ( P = 0.0007) and 3% oxygen desaturation index ( P = 0.0016) after adjustment for age, gender, body mass index, alcohol habits, metabolic dyslipidaemia, hypertension, statin use and study site. The adjusted mean value of HbA 1c increased from 6.68% in the lowest quartile of the apnea–hypopnea index (<17) to 7.20% in the highest quartile of the apnea–hypopnea index (>61; P = 0.033 for linear trend). In treated patients with diabetes, HbA 1c was associated with non‐sleep variables, including age, metabolic dyslipidaemia and insulin use, but not with obstructive sleep apnea severity. Obstructive sleep apnea may adversely affect glucose control in patients with newly diagnosed and untreated type 2 diabetes, but may have a limited impact in patients with overt type 2 diabetes receiving anti‐diabetic medications.