帮助 关于我们

返回检索结果

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

查看参考文献23篇

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

参考文献 共 23 共2页

1.  Resnick H E. Diabetes and sleep disturbances: Findings from the Sleep Heart Health Study. Diabetes Care,2003,26:702-709 被引 17 次    
2.  Einhorn D. Prevalence of sleep apnea in a population of adults with type 2 diabetes mellitus. Endocr Pract,2007,13:355-362 被引 9 次    
3.  West S D. Prevalence of obstructive sleep apnoea in men with type 2 diabetes. Thorax,2006,61:945-950 被引 19 次    
4.  Sharafkhaneh A. Sleep apnea in a high risk population: A study of Veterans Health Administration beneficiaries. Sleep Med,2004,5:345-350 被引 1 次    
5.  Berry R B. Rules for scoring respiratory events in sleep: Update of the 2007 AASM Manual for the Scoring of Sleep and Associated Events. Deliberations of the Sleep Apnea Definitions Task Force of the American Academy of Sleep Medicine. J Clin Sleep Med,2012,8:597-619 被引 105 次    
6.  Gruber A. Obstructive sleep apnoea is independently associated with the metabolic syndrome but not insulin resistance state. Cardiovasc Diabetol,2006,5:22 被引 9 次    
7.  Schahin S P. Long-term improvement of insulin sensitivity during CPAP therapy in the obstructive sleep apnoea syndrome. Med Sci Monit,2008,14:CR117-CR121 被引 2 次    
8.  Louis M. Effects of acute intermittent hypoxia on glucose metabolism in awake healthy volunteers. J Appl Physiol (1985),2009,106:1538-1544 被引 10 次    
9.  Stamatakis K A. Effects of sleep fragmentation on glucose metabolism in normal subjects. Chest,2010,137:95-101 被引 17 次    
10.  Wang X. Obstructive sleep apnoea and the risk of type 2 diabetes: A meta-analysis of prospective cohort studies. Respirology,2013,18:140-146 被引 7 次    
11.  Pamidi S. Eight hours of nightly continuous positive airway pressure treatment of obstructive sleep apnea improves glucose metabolism in patients with prediabetes. A randomized controlled trial. Am J Respir Crit Care Med,2015,192:96-105 被引 2 次    
12.  Iftikhar I H. Meta-analyses of the association of sleep apnea with insulin resistance, and the effects of CPAP on HOMA-IR, adiponectin, and visceral adipose fat. J Clin Sleep Med,2015,11:475-485 被引 6 次    
13.  Pamidi S. Eight Hours of Nightly CPAP Treatment of Obstructive Sleep Apnea Improves Glucose Metabolism in Prediabetes: A Randomized Controlled Trial. Am J Respir Crit Care Med,2015(Epub ahead of print) 被引 1 次    
14.  Dorkova Z. Effects of continuous positive airway pressure on cardiovascular risk profile in patients with severe obstructive sleep apnea and metabolic syndrome. Chest,2008,134:686-692 被引 6 次    
15.  Knutson K L. Role of sleep duration and quality in the risk and severity of type 2 diabetes mellitus. Arch Intern Med,2006,166:1768-1774 被引 9 次    
16.  Shpirer I. Normal and elevated HbA1C levels correlate with severity of hypoxemia in patients with obstructive sleep apnea and decrease following CPAP treatment. Sleep Breath,2012,16:461-466 被引 5 次    
17.  Feng Y. Effects of continuous positive airway pressure therapy on glycaemic control, insulin sensitivity and body mass index in patients with obstructive sleep apnoea and type 2 diabetes: A systematic review and meta-analysis. NPJ Prim Care Respir Med,2015,25:15005 被引 4 次    
18.  Torrella M. Intermittent hypoxia is an independent marker of poorer glycaemic control in patients with uncontrolled type 2 diabetes. Diabetes Metab,2015(Epub ahead of print) 被引 1 次    
19.  De Luca Canto G. Biomarkers associated with obstructive sleep apnea: A scoping review. Sleep Med Rev, C,2014,23:28-45 被引 2 次    
20.  Tatsumi K. Sleep oxygen desaturation and circulating leptin in obstructive sleep apnea-hypopnea syndrome. Chest,2005,127:716-721 被引 8 次    
引证文献 9 篇

1 肖海鹏 重视糖尿病伴发病的防控 中华医学杂志,2015,95(44):3561-3562
被引 0 次

2 郭立新 睡眠障碍与糖尿病的发生及代谢异常控制 中华医学杂志,2015,95(44):3563-3564
被引 0 次

显示所有9篇文献

论文科学数据集
PlumX Metrics
相关文献

 作者相关
 关键词相关
 参考文献相关

版权所有 ©2008 中国科学院文献情报中心 制作维护：中国科学院文献情报中心
地址：北京中关村北四环西路33号 邮政编码：100190 联系电话：(010)82627496 E-mail:cscd@mail.las.ac.cn 京ICP备05002861号-4 | 京公网安备11010802043238号