Subjects with Type 2 Diabetes may have Obstructive Sleep Apnoea even at Lower BMI Values (original) (raw)
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Open Journal of Respiratory Diseases, 2021
Background: Obstructive sleep apnea syndrome (OSAS) may promote hyperglycemia, insulin resistance, and hypertension (HTN). Purpose: To evaluate if there is a relationship between the severity of OSA and the severity of type 2 diabetes mellitus (T2DM) and HTN in our patients, aiming to understand and optimize the control for comorbidities. Materials and Methods: Patients referred for polysomnography (PSG) were retrospectively recruited during the period from October 2017 to August 2020. A STOP-BANG questionnaire formed eight questions was used to assess the risk of OSAS. We divided the patients into two groups; group 1, who have snoring without T2DM, and group 2, who have snoring with T2DM. PSG was completed for all subjects and data were collected for each patient including apnoea hypopnea index (AHI), mean arterial oxygen saturation (SaO 2), and Nadir SaO 2 recorded during PSG. Anthropometric data, medical history, and medications for T2DM (for group 2) and HTN and HbA1c were collected (for group 2). AHI was used to evaluate the severity of OSA and its relation to T2DM and HTN. Results: The study included 300 patients who met the inclusion criteria with mean age of 49.9 ± 13.6 years. The majority of subjects (56.3%) were males and the mean body mass index (BMI) was 38.0 ± 8.4 kg/m 2. Forty-two percent had HTN and 32.7% had T2DM. OSA was diagnosed in 209 patients (69.7%). OSA was more detected among those with increased age, increased BMI, and those with HTN and T2DM.
RISK OF OBSTRUCTIVE SLEEP APNEA IN PATIENTS WITH TYPE 2 DIABETES MELLITUS
Introduction: Many studies provided a positive relationship between Obstructive sleep apnea and diabetes mellitus type2. It has been revealed that almost one third of middle aged Saudi papulation are at risk for OSA. The aim of this study is to compare the risk of OSA between diabetic patients and non-diabetic middle aged Saudi population. Materials and Methods: This was a cross-sectional questionnaire-based study conducted in King Fahad hospital diabetes center in AL-Ahsaa, Saudi Arabia. Saudi patients aged 18 years and above with diabetes type 2 who visited the outpatient clinics in July and august 2015 where engaged in the study. Medical records were reviewed for demographic characteristics, weight, height, body mass index (BMI), blood pressure, glycated hemoglobin, and chronic medical conditions. Berlin questionnaire was used to assess the risk of OSA. Results: Based on berlin questionnaire, 45 out of 147 of sample (30.6%) are at high risk for OSA. 43.4% who have hypertension in high risk of OSA. Also, 33% of patients with BMI above or equal 25 are in high risk for OSA. There is no significant relation between age, gender and HA1C. Contrariwise, there is significant relation between presence of HTN and BMI above or equal 25 with increased risk for OSA. Conclusion: Hypertension, overweight and obesity contribute in high risk of OSA in diabetic patients. There is no difference between diabetic patients and middle aged Saudi population regarding the risk of OSA.
Study of Obstructive Sleep Apnea in Obese Patients with Type 2 Diabetes Mellitus
JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2020
This was a cross-sectional study carried out in patients attending the OutPatient Departments (OPDs) of TB and Respiratory Diseases and Endocrinology, from 1 st September 2017 to 31 st March 2019 after getting an approval from the Ethical Committee (Dean/2017/ EC/198). The consent was taken from participants. Inclusion criteria: Participants included in the study were obese adults with T2DM. Exclusion criteria: Pregnant females, participants taking treatment for OSA, having any chronic pulmonary condition, respiratory failure, or on domiciliary oxygen therapy, having any pre-existing cardiovascular disease, hepatic disease or neuromuscular/neurological disorders, having history of drug abuse or alcoholism (consumption of alcohol (ethanol) for more than 4 nights per week as per CAGE criteria) [4]. Data on demographic characteristics, medical history, medications, habits and sleep using Epworth Sleepiness Scale [5] were obtained before the initiation of overnight unattended polysomnography. Each patient's height, weight, neck circumference, waist circumference, abdominal girth and BMI were measured. Routine blood investigations like Complete Blood Count (CBC), Liver Function Test (LFT), Renal Function Test (RFT), blood sugar level i.e., fasting blood sugar and postprandial blood sugar and HbA1c were done. T2DM was diagnosed by using the following criteria [6] i.e., symptoms of diabetes plus random blood glucose concentration ≥200 mg/dL and/or Fasting plasma glucose ≥126 mg/dL, and/or Haemoglobin A1c (HbA1c) ≥6.5%, and/or 2-h plasma glucose ≥200 mg/dL. Obesity (BMI >30 Kg/m 2) was classified [7] using BMI into Class 1 (30-34.99 Kg/m 2), Class 2 (35-39.99 Kg/m 2) and Class 3 (≥40.0 Kg/m 2). Based on AHI, OSA was classified [8] into Mild (AHI 5 to <15), Moderate (AHI 15 to 30) and Severe (AHI >30) groups. STATISTICAL ANALYSIS The statistical analysis was done using statistical software SPSS for windows (version 16). Chi-square test was used for non-parametric variables. Student's t-test was used for comparing two groups. The p-value <0.05 was stated as statistically significant. RESULTS The baseline characteristics of the population are given in [Table/Fig-1].
International Journal of Diabetes in Developing Countries, 2015
Obstructive sleep apnea (OSA) and excessive daytime sleepiness (EDS) are common in patients with type 2 diabetes mellitus (T2DM). This study was aimed to evaluate the prevalence and risk factors of the OSA and EDS among Iranian patients with T2DM. We conducted a cross-sectional study on randomly selected 173 patients with T2DM aged 30 to 65. We assessed daytime sleepiness using the Epworth sleepiness scale and risk of OSA using the STOP-BANG questionnaire. Further information was demographic and anthropometric characteristics plus metabolic profile. Of all, 122 (74 %) patients were at high risk for OSA and 78 (45 %) patients suffered from EDS. Patients at high risk for OSA were older and had higher BMI, waist circumference, neck circumference, systolic, and diastolic blood pressure. In addition, men were significantly at a higher risk for OSA than women. Logistic regression revealed that age, male sex, and neck circumference were independent predictors of risk for OSA. The only independent predictor of EDS was age. Patients with T2DM are at high risk for OSA; also, daytime sleepiness is highly prevalent in this population. Our results indicated that the evaluation of OSA, EDS, and their risk factors should be included in the clinical management of patients with T2DM.
Diabetes, Obesity and Metabolism, 2009
Recent attention has been drawn to the close association between obstructive sleep apnoea (OSA) and type 2 diabetes mellitus (T2DM). Debate has included much discussion about cause and effect with mechanisms proposed whereby one condition might cause the other. However, both clearly share a common phenotype, namely, obesity that overlaps considerably with the other components of the metabolic syndrome, hypertension and hyperlipidaemia. It would therefore appear likely that all are manifestations of the same basic pathological processes. Possible interacting aetiological mechanisms are reviewed along with treatment options. A recent report by the International Diabetes Federation has made recommendations to raise awareness of possible OSA in patients with T2DM and also for screening for hypertension, hyperlipidaemia and T2DM in patients with known OSA. The clinical implications are discussed.
Risk for Obstructive Sleep Apnea among People with Diabetes
Bahrain Medical Bulletin, 2014
Result: A total of 455 questionnaires were analyzed. All patients included were type 2. The mean age was 56.6 years. High risk for OSA was present in 173 (38%) patients. It was more common among females (P=0.013). There was no significant age difference (P=0.75). The risk of OSA increased significantly with BMI≥35 (P<0.001). No significant difference was found between low and high risk in the control of glycated hemoglobin, lipid profile, and the number of drugs used. Three (1.7%) patients from the high OSA risk and 2 (0.71%) from the low risk (282) had previous OSA diagnosis. Conclusion: More than one-third of our patients were high risk for OSA. Screening for OSA among diabetics is lacking despite the presence of high number of at risk patients. Increasing awareness of the treating physicians is needed.
Obstructive sleep apnoea and type 2 diabetes: whose disease is it anyway?
Practical Diabetes International, 2011
The association between type 2 diabetes mellitus (T2DM) and obstructive sleep apnoea (OSA) is increasingly recognised. Both conditions are rising in prevalence due to the increased prevalence in obesity, which plays a key role in both disorders. Emerging evidence suggests that T2DM and OSA may also be related independently of obesity. This raises the possibility that identifying and treating OSA in patients with diabetes could have an important impact on diabetes control and cardiovascular health. This article is a summary of the implications of OSA for patients with T2DM.
Journal of Clinical Medicine
Background: Type 2 diabetes mellitus (T2DM) is associated with increased mortality and morbidity, including cardiovascular diseases and obstructive sleep apnea (OSA). The aim of this study was to assess the associations between cardiovascular risk, chronic diabetes complications and the risk of OSA in adult patients with T2DM. Methods: The study included 529 patients with T2DM in whom moderate-to-severe OSA risk was assessed using the STOP-Bang questionnaire, dividing the subjects into two groups: group 1: STOP-Bang score <5, and group 2: STOP-Bang score ≥5, respectively. In all the subjects, cardiovascular risk was assessed using the UKPDS risk engine. Statistical analysis was performed using SPSS 26.0, the results being statistically significant if p value was <0.05. Results: 59% of the subjects scored ≥5 on the STOP-Bang questionnaire. We recorded statistically significant differences between the two groups regarding diabetes duration, HbA1c, HOMA-IR, albuminuria, as well a...
Journal of Endocrinological Investigation, 2021
Introduction Obstructive sleep apnoea (OSA) is an underdiagnosed condition frequently associated with glycaemic control impairment in patients with type 2 diabetes. Aim To assess the relationship between glycometabolic parameters and OSA in obese non-diabetic subjects. Methods Ninety consecutive subjects (mean age 44.9 ± 12 years, mean BMI 42.1 ± 9 kg/m2) underwent polysomnography and a 2-h oral glucose tolerance test (OGTT). Results OSA was identified in 75% of subjects, with a higher prevalence of males compared to the group of subjects without OSA (62% vs 32%, p = 0.02). Patients with OSA had comparable BMI (42.8 kg/m2 vs 39.4 kg/m2), a higher average HbA1c (5.8% vs 5.4%, p < 0.001), plasma glucose at 120 min during OGTT (2 h-PG; 123 mg/dl vs 97 mg/dl, p = 0.009) and diastolic blood pressure (81.1 mmHg vs 76.2 mmHg, p = 0.046) than obese subjects without OSA. HbA1c and 2 h-PG were found to be correlated with the apnoea-hypopnoea index (AHI; r = 0.35 and r = 0.42, respectively)...
Journal of Diabetes Research, 2018
This study explored the relationship between obstructive sleep apnea (OSA) and the presence of any diabetes-related complications in type 2 diabetes and whether this was mediated by hypertension. Secondly, the relationship between OSA severity and estimated glomerular filtration rate (eGFR) was investigated. A total of 131 patients participated. OSA was diagnosed using a home monitor, and severity was measured by apnea-hypopnea index (AHI) and oxygen desaturation index (ODI). OSA was found in 75.6% of the participants, 40.5% with moderate-to-severe degree. Any diabetes-related complications (retinopathy, neuropathy, nephropathy, or coronary artery disease) were present in 55.5%, and 70.2% of the participants had hypertension. Mediation analysis indicated that, compared to those with mild or no OSA, those with moderate-to-severe OSA were 3.05 times more likely to have any diabetes-related complications and that this relationship was mediated by the presence of hypertension. After adj...