Prevalence of undiagnosed glucose intolerance and type 2 diabetes in patients with moderate-to-severe obstructive sleep apnea syndrome

Abstract

Purpose Overweight and obesity are major causal factors for obstructive sleep apnea syndrome (OSAS), providing insight into why one third of patients with OSAS suffer from diabetes mellitus and another third from glucose intolerance. However, a significant proportion of the general population remains undiagnosed for glucose metabolism disorders. The primary aim of this study was to establish the prevalence of known and newly diagnosed glucose metabolism disorders in patients with moderate and severe OSAS referred to the sleep lab for continuous positive airway pressure (CPAP) therapy. Methods We prospectively included consecutive patients with moderate or severe OSAS referred for CPAP therapy. A fasting blood sample was collected to determine glycosylated hemoglobin (HbA1c), glucose, and homeostatic model assessment (HOMA) index. Baseline demographic data and medication intake were recorded. Results Of 280 consecutive patients (70% men, mean ± SD body mass index 33 ± 7 kg/m 2 , apnea-hypopnea index 49 ± 25), 22% exhibited diabetes and 44% glucose intolerance. Undiagnosed diabetes and glucose intolerance was found in 79 of 280 patients (28%). Insulin resistance was associated with OSAS severity in multivariate linear regression analysis (regression coefficient 2.40 [95% CI 0.07-4.72]; p = 0.04). Conclusion In this population of overweight and obese patients with moderate and severe OSAS, 66% of patients had diabetes or glucose intolerance and 28% were newly diagnosed. Diabetes and glucose intolerance were not related to OSAS severity, contrary to insulin resistance. These data suggest that there is value in systematic screening for glucose metabolism disorders in all patients with moderate and severe OSAS.

Endocrine disorders in obstructive sleep apnoea syndrome: A bidirectional relationship

“…48 Another recent study showed that glucose metabolism disorders in OSA may go unrecognized and that 28% of moderate-to-severe OSA patients have undiagnosed glucose intolerance (GIT) or T2D. 49 Systematic screening should be proposed in this population who have a lot of comorbidities and who meet the criteria for testing for diabetes or prediabetes according to American Diabetes Association (ADA) guidelines. 50…”

Prevalence of acromegaly in moderate‐to‐severe obstructive sleep apnoea

“…Furthermore, a magnetic resonance image (MRI) of the pituitary was proposed in patients with a confirmed increase in IGF‐1 together with a high clinical suspicion (including typical physical signs (face, hands, feet, enlarged tongue) and anamnestic features (headache, transpiration, fertility issues and joint pain)), and/or an inadequate suppression of GH under OGTT. We described our study groups in detail in a previous paper of the prevalence of OSAS with diabetes 8 . The study protocol was approved by the Saint‐Pierre University Hospital ethics committee (AK/16‐01‐18/4613).…”

“…We described our study groups in detail in a previous paper of the prevalence of OSAS with diabetes. 8 The study protocol was approved by the Saint-Pierre University Hospital ethics committee (AK/16-01-18/ 4613).…”

Can a sleep disorder intervention-embedded self-management programme contribute to improve management of diabetes? A pilot single-arm pretest and post-test study

“…As DM and IGT are associated with a higher risk of developing cardiovascular disease and death, prevention and management of these health problems are important public health goals. Studies have shown that the prevalence of obstructive sleep apnoea (OSA) in patients with diabetes is estimated to be 23%–48% 6 7. Patients with OSA and type 2 DM are at increased risk of diabetic peripheral neuropathy,8 restless legs syndrome9 and frequent urination due to hyperglycaemia 10.…”