Sleep Apnea Severity not linked to blood sugar control in T2DM

Obstructive sleep apnea (OSA) has been identified as an independent risk factor for T2DM potential mechanisms include sympathetic activation, oxidative stress, inflammation, and/or hypothalamic–pituitary–adrenal axis dysfunction. However, the OSA adverse impacts on the pancreatic islet β-cell function remain unclear. Therefore, Dr Babak Mokhlesi and his team conducted a study to investigate the association of OSA and short sleep duration with β-cell function in overweight/obese adults with prediabetes or recently diagnosed treatment-naive type 2 diabetes.

Researchers used data of run-in and baseline phases of the RISE Adult Medication Study. They included 221 participants who completed the baseline procedures for the RISE study, polysomnography and 1 week of actigraphy. Of these patients, 73% had prediabetes, 27% had recently diagnosed treatment-naive T2D. They analyzed both insulin sensitivity and β-cell responses to identify which components of the glucose regulatory pathway were associated with OSA and sleep duration. They used an adjusted regressive model to evaluate the associations of measures of OSA and actigraphy-derived sleep duration with HbA1c, OGTT-derived, and clamp-derived outcomes. They determined the OSA as an apnea-hypopnea index (AHI) of five or more events per hour, was present in 89% of the participants (20% mild, 28% moderate, 41% severe).

Key findings of the study were:

• The researchers observed that the mean ± SD objective sleep duration by actigraphy was 6.6 ± 1.0 h/night.
• They noted that higher AHI was associated with higher HbA1c.
• However, they also noted that the OSA severity, measured either by AHI as a continuous variable or by categories of OSA severity and sleep duration (continuous or <6 vs ≥6 h) were not associated with fasting glucose, 2-h glucose, insulin sensitivity, or β-cell responses.

The authors concluded, " In this baseline cross-sectional analysis of the RISE clinical trial of adults with prediabetes or recently diagnosed, untreated type 2 diabetes, the prevalence of OSA was high. Although some measures of OSA severity were associated with HbA1c, OSA severity and sleep duration were not associated with measures of insulin sensitivity or β-cell responses."

For further information:

https://care.diabetesjournals.org/content/early/2021/02/05/dc20-2127