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Effect of Continuous Positive Airway Pressure Therapy on Glycemic Excursions and Insulin Sensitivity in Patients with Obstructive Sleep Apnea-hypopnea Syndrome and Type 2 Diabetes

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Guo Lixin 1 *   Zhao Xin 2   Pan Qi 1   Sun Xue 1   Li Hui 1   Wang Xiaoxia 1   Zhang Lina 1   Wang Yao 1  
文摘 Background: For patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) and type 2 diabetes mellitus (T2DM), the night sleep interruption and intermittent hypoxia due to apnea or hypopnea may induce glycemic excursions and reduce insulin sensitivity. This study aimed to investigate the effect of continuous positive airway pressure (CPAP) therapy in patients with OSAHS and T2DM. Methods: Continuous glucose monitoring system (CGMS) was used in 40 patients with T2DM and newly diagnosed OSAHS. The measurements were repeated after 30 days of CPAP treatment. Subsequently, insulin sensitivity and glycohemoglobin (HbAlc) were measured and compared to the pretreatment data. Results: After CPAP therapy, the CGMS indicators showed that the 24-h mean blood glucose (MBG) and the night time MBG were significantly reduced (P < 0.05 and P = 0.03, respectively). The mean ambulatory glucose excursions (MAGEs) and the mean of daily differences were also significantly reduced (P < 0.05 and P = 0.002, respectively) compared to pretreatment levels. During the night, MAGE also significantly decreased (P = 0.049). The differences between the highest and lowest levels of blood glucose over 24 h and during the night were significantly lower than prior to CPAP treatment (P < 0.05 and P = 0.024, respectively). The 24 h and night time durations of high blood glucose (>7.8 mmol/L and > 11.1 mmol/L) decreased (P < 0.05 and P < 0.05, respectively) after the treatment. In addition, HbAlc levels were also lower than those before treatment (P < 0.05), and the homeostasis model assessment index of insulin resistance was also significantly lower than before CPAP treatment (P = 0.034). Conclusions: CPAP therapy may have a beneficial effect on improving not only blood glucose but also upon insulin sensitivity in T2DM patients with OSAHS. This suggests that CPAP may be an effective treatment for T2DM in addition to intensive diabetes management.
来源 Chinese Medical Journal ,2015,128(17):2301-2306 【核心库】
DOI 10.4103/0366-6999.163382
关键词 Continuous Glucose Monitoring System ; Continuous Positive Airway Pressure ; Obstructive Sleep Apnea-hypopnea Syndrome ; Type 2 Diabetes Mellitus
地址

1. Department of Endocrinology, Beijing Hospital, Beijing, 100730  

2. Department of General Medicine, First Hospital of China Medical University, Liaoning, Shenyang, 110001

语种 英文
文献类型 研究性论文
ISSN 0366-6999
学科 内科学;耳鼻咽喉科学
基金 supported by the grant from the Foundation of Beijing Municipal Science and Technology Commission
文献收藏号 CSCD:5507002

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