The effect of treatment of obstructive sleep apnea on glycemic control in type 2 diabetes

Jonathan E. Shaw, Naresh M. Punjabi, Matthew T. Naughton, Leslee Willes, Richard M. Bergenstal, Peter A. Cistulli, Greg R. Fulcher, Glenn N. Richards, Paul Z. Zimmet

Research output: Contribution to journalArticle

59 Citations (Scopus)

Abstract

Rationale: There is uncertainty about the effects of treating obstructive sleep apnea on glycemic control in patients with type 2 diabetes. Objectives: To determine whether treatment of obstructive sleep apnea in patients with type 2 diabetes improves glycemic control. Methods: In this trial, we randomized patients with type 2 diabetes and no previous diagnosis of obstructive sleep apnea, with a glycated hemoglobin level of 6.5-8.5%, and an oxygen desaturation index of 15 or more events per hour to positive airway pressure therapy or to usual care. Measurements and Main Results: A total of 416 patients met the entry criteria as determined by each site and were randomized. Of the 298 participants who met centrally adjudicated entry criteria, no differences betweenthestudy groupswereseenforchange inglycated hemoglobin. Furthermore, there were no between-group differences when analyses were restricted to those with poorer baseline glycemic control, those with more severe sleep apnea, or those who were adherent to therapy. A greater fall in diastolic blood pressure occurred in the positive airway pressure group than in the usual care group (23.5 mm Hg vs. 21.5 mm Hg; P < 0.07). This difference was significant in those who were adherent to positive airway pressure therapy (24.4 mm Hg vs. 21.6 mm Hg; P = 0.02). There was a significant reduction in sleepiness in the positive airway pressure therapy group (P, 0.0001). Quality of life assessment revealed improvements in vitality, mental health, and mental component summary scores in the positive airway pressure therapy group. Conclusions: This trial showed no effect of positive airway pressure therapy on glycemic control in patients with relatively well-controlled type 2 diabetes and obstructive sleep apnea.

LanguageEnglish
Pages486-492
Number of pages7
JournalAmerican Journal of Respiratory and Critical Care Medicine
Volume194
Issue number4
DOIs
Publication statusPublished - 15 Aug 2016

Keywords

  • Diabetes mellitus
  • Glycemic control
  • Positive airway pressure therapy
  • Sleep-disordered breathing

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine

Cite this

Shaw, J. E., Punjabi, N. M., Naughton, M. T., Willes, L., Bergenstal, R. M., Cistulli, P. A., ... Zimmet, P. Z. (2016). The effect of treatment of obstructive sleep apnea on glycemic control in type 2 diabetes. American Journal of Respiratory and Critical Care Medicine, 194(4), 486-492. https://doi.org/10.1164/rccm.201511-2260OC
Shaw, Jonathan E. ; Punjabi, Naresh M. ; Naughton, Matthew T. ; Willes, Leslee ; Bergenstal, Richard M. ; Cistulli, Peter A. ; Fulcher, Greg R. ; Richards, Glenn N. ; Zimmet, Paul Z. / The effect of treatment of obstructive sleep apnea on glycemic control in type 2 diabetes. In: American Journal of Respiratory and Critical Care Medicine. 2016 ; Vol. 194, No. 4. pp. 486-492.
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abstract = "Rationale: There is uncertainty about the effects of treating obstructive sleep apnea on glycemic control in patients with type 2 diabetes. Objectives: To determine whether treatment of obstructive sleep apnea in patients with type 2 diabetes improves glycemic control. Methods: In this trial, we randomized patients with type 2 diabetes and no previous diagnosis of obstructive sleep apnea, with a glycated hemoglobin level of 6.5-8.5{\%}, and an oxygen desaturation index of 15 or more events per hour to positive airway pressure therapy or to usual care. Measurements and Main Results: A total of 416 patients met the entry criteria as determined by each site and were randomized. Of the 298 participants who met centrally adjudicated entry criteria, no differences betweenthestudy groupswereseenforchange inglycated hemoglobin. Furthermore, there were no between-group differences when analyses were restricted to those with poorer baseline glycemic control, those with more severe sleep apnea, or those who were adherent to therapy. A greater fall in diastolic blood pressure occurred in the positive airway pressure group than in the usual care group (23.5 mm Hg vs. 21.5 mm Hg; P < 0.07). This difference was significant in those who were adherent to positive airway pressure therapy (24.4 mm Hg vs. 21.6 mm Hg; P = 0.02). There was a significant reduction in sleepiness in the positive airway pressure therapy group (P, 0.0001). Quality of life assessment revealed improvements in vitality, mental health, and mental component summary scores in the positive airway pressure therapy group. Conclusions: This trial showed no effect of positive airway pressure therapy on glycemic control in patients with relatively well-controlled type 2 diabetes and obstructive sleep apnea.",
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Shaw, JE, Punjabi, NM, Naughton, MT, Willes, L, Bergenstal, RM, Cistulli, PA, Fulcher, GR, Richards, GN & Zimmet, PZ 2016, 'The effect of treatment of obstructive sleep apnea on glycemic control in type 2 diabetes', American Journal of Respiratory and Critical Care Medicine, vol. 194, no. 4, pp. 486-492. https://doi.org/10.1164/rccm.201511-2260OC

The effect of treatment of obstructive sleep apnea on glycemic control in type 2 diabetes. / Shaw, Jonathan E.; Punjabi, Naresh M.; Naughton, Matthew T.; Willes, Leslee; Bergenstal, Richard M.; Cistulli, Peter A.; Fulcher, Greg R.; Richards, Glenn N.; Zimmet, Paul Z.

In: American Journal of Respiratory and Critical Care Medicine, Vol. 194, No. 4, 15.08.2016, p. 486-492.

Research output: Contribution to journalArticle

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AU - Punjabi, Naresh M.

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AU - Willes, Leslee

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N2 - Rationale: There is uncertainty about the effects of treating obstructive sleep apnea on glycemic control in patients with type 2 diabetes. Objectives: To determine whether treatment of obstructive sleep apnea in patients with type 2 diabetes improves glycemic control. Methods: In this trial, we randomized patients with type 2 diabetes and no previous diagnosis of obstructive sleep apnea, with a glycated hemoglobin level of 6.5-8.5%, and an oxygen desaturation index of 15 or more events per hour to positive airway pressure therapy or to usual care. Measurements and Main Results: A total of 416 patients met the entry criteria as determined by each site and were randomized. Of the 298 participants who met centrally adjudicated entry criteria, no differences betweenthestudy groupswereseenforchange inglycated hemoglobin. Furthermore, there were no between-group differences when analyses were restricted to those with poorer baseline glycemic control, those with more severe sleep apnea, or those who were adherent to therapy. A greater fall in diastolic blood pressure occurred in the positive airway pressure group than in the usual care group (23.5 mm Hg vs. 21.5 mm Hg; P < 0.07). This difference was significant in those who were adherent to positive airway pressure therapy (24.4 mm Hg vs. 21.6 mm Hg; P = 0.02). There was a significant reduction in sleepiness in the positive airway pressure therapy group (P, 0.0001). Quality of life assessment revealed improvements in vitality, mental health, and mental component summary scores in the positive airway pressure therapy group. Conclusions: This trial showed no effect of positive airway pressure therapy on glycemic control in patients with relatively well-controlled type 2 diabetes and obstructive sleep apnea.

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