Obstructive sleep apnea and diabetes mellitus

Background: There is convincing evidence that obstructive sleep apnea (OSA) is highly associated with impaired glucose metabolism.

Objectives: Analyze the prevalence of OSA in type 1 and type 2 diabetes mellitus (DM) patients. Evaluate the influence of OSA on glycemic control.

Methods: The adult patients with diabetes mellitus (DM) followed in the department of internal medicine were referred to our Sleep Unit. A home respiratory polygraphy was then performed on all patients with body mass index (BMI) <40 kg/m(2). The glycemic control was assessed by the value of glycated hemoglobin (Hba1c) in the previous 3 months.

Results: A total of 46 patients were studied (20 men and 26 women), the mean age was 50±15 years and mean BMI was 28.6±4.9 kg/m(2). The mean Hba1c was 8.3±1.2. Twenty three patients had type 2 DM and 23 patients had type 1 DM. Twenty nine patients (63.0%) had OSA and 8.7% had severe OSA (AHI>30/h). The mean CT90 was 5.3±12.5 and the mean AHI was 13.6±18.3. The mean AHI was similar between type 1 and type 2 DM (15.7±24.5 Vs 11.6±8.9; p=0.46). The AHI was not correlated with the BMI. Type 2 DM patients with poor glycemic control (HbA1c>7.5%) had a significantly higher mean AHI (14.3±9.0 vs 6.4±6.2; p=0.038). This difference did not remain significant after adjustment for BMI (p=0.151).

Conclusions: The prevalence of OSA in type 1 DM is similar to that found in type 2 DM. We note the high prevalence of OSA in younger patients with type 1 DM.