58% of TYPE 2 DIABETES MELLITUS 1 patients suffer from Obstructive Sleep Apnea(OSA).

OSA is linked to other diseases

50% of patients with Heart failure2 suffer from Sleep apnea

35% of patients with Hypertension3 suffer from sleep apnea

77% if patients with Obesity4 suffer from Sleep Apnea

Research Society for Study of Diabetes in India (RSSDI)

Recommends implementation of screening, diagnosis, and Treatment of OSA in patients with T2DM at initial stages to reduce the risk of cardiovascular diseases and improve quality of life.

Diagnose Sleep Apnea in Diabetic Patients


Sleep apnea is a common disorder in which the upper airway of the body repeatedly collapses. This leads to the stoppage of breathing and fall in oxygen levels which leads to fragmentation of sleep

Obstructive Sleep Apnea Symptoms

Loud Snoring

Daytime Sleepiness

Not feeling fresh even after a full night's sleep

Gasping for breath during sleep

There is a Viscious cycle involving Obstructive Sleep Apnea (OSA) and Diabetes Mellitus.

Obstructive Sleep Apnea leads to Type 2 Diabetes Mellitus

Type 2 Diabetes Mellitus leads to Obstructive Sleep Apnea

RSSDI clinical practice recommendations for screening, diagnosis, and treatment in T2DM with Obstructive Sleep Apnea


The possibility of OSA should be considered in the assessment of all individuals with T2DM and metabolic syndrome

All individuals with T2DM should be assessed for every symptom of OSA

Individuals with T2DM should be referred to a specialist at an early stage to diagnose, and start therapy.

Managment of OSA should focus primarily on weight reduction in over weight and obese people.

Continuous Positive Airway Pressure(CPAP) is the current best treatment for moderate to severe OSA : RSSDI Guidelines States

Impact of Treatment With CPAP*

Impact on respiratory events

Impact on blood glucose levels


Excellent control of HBA1c with CPAP treatment and half the medication- 5 years*

3.9% lesser HBA1c levels.

Drug Load-Reduced to Half.

12% increase in patients quality of Life.



Year 3:
Significant Reduction in Systolic Blood Pressure in CPAP group.5

Year 4:
Overall Blood Pressure significantly reduced in CPAP group.

IDF* recommends CPAP therapy as a gold standard therapy in patients with diabetes,also having Obstructive Sleep Apnea(OSA)

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1. Arosohn RS et al. Am J Respir Crit Care Med. 2010 Mar 1;181(5):507-13.
2. Foster GD et al. Diabetes Care.2009 Jun;32(6):1017-9.
# AASM - American Association of Sleep Medicine
* AHI - Apnea Hypoapnea Index
* HRQol - Health Related Quality of Life

*Extra Content*

Commonalities between Obstructive Sleep Apnea and Type 2 Diabetes Mellitus

Patients suffer from obesity

Smokers,alcohol consumers, and physically inactive people are at risk

Both increase the risk of cardiovascular diseases and other complications

How to access OSA in Diabetic Patients ?

References

1.Resnick HE,Redline S,Shahar E,et al.Diabetes and sleep disturbances:findings from the sleep heart health study.Diabetes care 2003;26:702-709 2.Javaheri S et al.Sleep Apnea Testing and Outcomes in a Large Cohort of Medicare Benefiaries with Newly Diagnosed Heart FailureAMJ Respir Crit Care Med 2011 3.Sjöström C, Lindberg E, Elmasry A, et al. Prevalence of sleep apnoea and snoring in hypertensive men: a population based study. Thorax 2002; 57: 4.O’Keeffe T,Patterson EJ.Evidence supporting routine plysonography before bariatric surgery.obes surg. 2004. 5.Guest HF et al.Diabetes Care.2014:37(5):1263-71 *.Chopra S er al. J Clin Endocrinol Metab.2017 Sep 1;102(9):3172-3181