CPAP treatment for type 2 diabetes patients with sleep apnea could improve glycemic control

Patients with obstructive sleep apnea and poorly-controlled type 2 diabetes who are treated with continuous positive airway pressure (CPAP) could experience improved blood glucose levels, research suggests.
CPAP is commonly used to treat patients with obstructive sleep apnea, which people with type 2 diabetes are more likely to suffer from. CPAP uses mild air pressure to keep the airways open during sleep, preventing them from becoming blocked.
Researchers at Autonoma University of Madrid wanted to investigate how CPAP affected glycemic control in patients with type 2 diabetes. The study, which analysed results from 50 patients with both obstructive sleep apnea and HbA1c levels over 6.5 per cent (47.5 mmol/mol), is believed to be the first randomised controlled trial of its kind.
Patients received CPAP or no treatment, while their usual type 2 diabetes medication remained unchanged. The patients ranged in age from 18 to 50 years and were studied for six months. The participants’ glucose control, insulin sensitivity, insulin resistance and levels of inflammatory proteins were all measured.
After six months, the CPAP group had statistically significant decreases in HbA1c levels and insulin resistance. They also had lower levels of IL-1beta and IL-6, which are inflammatory molecules, and higher levels of the hormone adiponecti, an important glucose regulator.
Because patients in the CPAP group also had lower LDL cholesterol, indicating a lower risk of cardiovascular disease, the researchers believe CPAP treatment could also have cardiovascular benefits for type 2 diabetes patients.
Senior study author Francisco Garcia-Rio, MD, PhD, said the findings suggest that “early identification of OSA in patients with type 2 diabetes, and assessment for metabolic abnormalities in those with OSA could reduce the cardiovascular disease risk of patients with these chronic diseases.”
The findings were published in the American Journal of Respiratory and Critical Care Medicine.

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