CPAP helps lower blood sugar in diabetics with sleep apnea: Study

China: Patients with type 2 diabetes (T2D) and sleep apnea when treated with CPAP experience improved insulin resistance and blood sugar control, finds a recent study in the journal Diabetes, Obesity and Metabolism. 

Obstructive sleep apnea (OSA) is a common chronic respiratory disorder characterized by sleep-induced recurrent upper airway collapse. After more than three decades from its first use, continuous positive airway pressure (CPAP) is still recognized as the gold standard treatment. In earlier studies, Sleep apnea has been linked with elevated blood sugar levels, suggesting people with the condition could be at an increased risk of cardiovascular illness and mortality.

Obstructive sleep apnea and T2D are two interacting epidemics and both have high prevalence and morbidity. Epidemiological and clinical studies have suggested that majority of T2D patients have OSA. Sleep apnea when untreated in these patients results in poor blood sugar control leading to acceleration of complications related to diabetes. CPAP is a non-pharmacological intervention which is the gold-standard treatment of OSA and is highly effective in relieving OSA symptoms and might be of benefit to diabetes patients too.

Wenli Shang, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, PR China, and colleagues performed the meta-analysis to determine the effects of continuous positive airway pressure (CPAP) treatment on insulin resistance and glycemic control in patients with T2D and obstructive sleep apnea. 

The researchers performed systematic search of online databases and included randomized controlled trials (RCTs) on treatment of T2D and OSA with CPAP, compared with sham CPAP or no CPAP. Seven trials consisting of 691 participants met the inclusion criteria.

CPAP presented significant effects on glycated hemoglobin (HbA1c) (SMD ‐0.32), fasting glucose (SMD ‐0.39), Homeostasis Model Assessment‐Insulin Resistance (HOMA‐IR) (SMD ‐1.05), systolic blood pressure (SBP) (SMD ‐1.18), and diastolic blood pressure (DBP) (SMD ‐1.29).

"CPAP treatment significantly improved glycemic control and insulin resistance, indicated by the decreased levels of HbA1c, fasting glucose, and HOMA‐IR in patients with type 2 diabetes and contemporary OSA," concluded the authors. 

"Benefits of CPAP on glycemic control and insulin resistance in patients with type 2 diabetes and obstructive sleep apnea: a meta‐analysis," is published in the journal Diabetes, Obesity and Metabolism.

DOI: https://dom-pubs.onlinelibrary.wiley.com/doi/10.1111/dom.14247