1a9197a36300891bd148a2e6c1698a1a pmc_32260419.pdf 0bfdf008de74811dec3c3ea7d21c22f2aaac0393 pmc_32260419.pdf bd6f01272c19c2e5397b2bb9e6d712cfa4d5230158725e706d1f260563352c38 pmc_32260419.pdf Title: Effect of Glucose Improvement on Nocturnal Sleep Breathing Parameters in Patients with Type 2 Diabetes: The Candy Dreams Study Subject: Type 2 diabetes exerts a negative impact on sleep breathing. It is unknown whether a long-term improvement in glycemic control ameliorates this effect. We conducted an interventional study with 35 patients with type 2 diabetes and obstructive sleep apnea (OSA) to explore this. At home, sleep breathing parameters were assessed at baseline and after a 4-month period in which antidiabetic therapy was intensified. Patients who decreased their body mass index 2kg/m2 were excluded. Those with an HbA1c reduction 0.5% were considered good responders (n = 24). After the follow-up, good responders exhibited an improvement in the apnea–hypopnea index (AHI: 26-1 (95% IC: 8.6–95.0) vs. 20.0 (4.0–62.4) events/hour, p = 0.002) and in time with oxygen saturation below 90% (CT90: 13.3 (0.4–69.0) vs. 8.1 (0.4–71.2) %, p = 0.002). No changes were observed in the group of non–responders (p = 0.722 and p = 0.138, respectively). The percentage of moderate and severe OSA decreased among good responders (p = 0.040). In the wider population, the change in HbA1c correlated positively to decreases in AHI (r = 0.358, p = 0.035) and negatively to increases in the minimum arterial oxygen saturation (r = -0.386, p = 0.039). Stepwise multivariate regression analysis showed that baseline AHI and the absolute change in HbA1c independently predicted decreased AHI (R2 = 0.496). The improvement of glycemic control exerts beneficial effects on sleep breathing parameters in type 2 diabetes, which cannot be attributed merely to weight loss. Keywords: diabetes; apnea; hypoxia; glycated hemoglobin Author: Liliana Gutiérrez-Carrasquilla, Carolina López-Cano, Enric Sánchez, Ferran Barbé, Mireia Dalmases, Marta Hernández, Angela Campos, Anna Michaela Gaeta, Paola Carmona, Cristina Hernández, Rafael Simó and Albert Lecube Creator: LaTeX with hyperref package Producer: pdfTeX-1.40.15 CreationDate: Sat Apr 4 15:12:35 2020 CEST ModDate: Sat Apr 4 15:12:35 2020 CEST Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 12 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 699476 bytes Optimized: no PDF version: 1.5 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- UOCZPF+URWPalladioL-Ital Type 1 Custom yes yes no 76 0 SIDZAU+URWPalladioL-Bold Type 1 Custom yes yes no 77 0 LZDGTK+Rpxb Type 1 Builtin yes yes no 78 0 JYPLJJ+VnURWPalladioL-Bold Type 1 Custom yes yes no 79 0 HJJIJY+URWPalladioL-Roma Type 1 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TrueType WinAnsi yes yes no 205 0 NJGIBF+PalatinoLinotype TrueType WinAnsi yes yes no 206 0 NJGILE+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 207 0 NJGIME+PalatinoLinotype,Bold CID TrueType Identity-H yes yes yes 208 0 NJGIMF+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 209 0 ZYYJXI+EURB10 Type 1 Builtin yes yes no 247 0 PDXFNG+PazoMath-Bold Type 1 Builtin yes yes no 248 0 MPUDFL+PazoMath Type 1 Builtin yes yes no 249 0 VSHNAE+Rpcxr Type 1 Builtin yes yes no 361 0 Jhove (Rel. 1.22.1, 2019-04-17) Date: 2020-11-18 06:47:31 CET RepresentationInformation: pmc_32260419.pdf ReportingModule: PDF-hul, Rel. 1.12.1 (2019-04-17) LastModified: 2020-07-06 03:51:20 CEST Size: 699476 Format: PDF Version: 1.5 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 0 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: ViewerPreferences: HideToolbar: false HideMenubar: false HideWindowUI: false FitWindow: true CenterWindow: false DisplayDocTitle: false NonFullScreenPageMode: UseNone Direction: L2R ViewArea: CropBox ViewClip: CropBox PrintArea: CropBox PageClip: CropBox PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: ぉのぴひはつふっぴどはのぜ〴〩਼㰠⽓ 䝯呯 䐠⡳散瑩潮⸲ Item: Title: ぅへばづひどねづのぴちぬぜ〴ぜ〰こづっぴどはのぜ〴〩਼㰠⽓ 䝯呯 䐠⡳畢獥捴楯渮㈮ㄩ‾㸊⡜㌷㙜㌷㝜〰こぴちぴづねづのぴぜ〴ぜ〰はのぜ〴ぜ〰ぅぴとどっびぜ〴〩਼㰠⽓ 䝯呯 䐠⡳畢獥捴楯渮㈮㈩‾㸊⡜㌷㙜㌷㝜〰こぴふつべぜ〴ぜ〰いづびどでのぜ〴ぜ〰ちのつぜ〴ぜ〰いづびっひどばぴどはのぜ〴ぜ〰はてぜ〴ぜ〰ぴとづぜ〴ぜ〰こぴふつべぜ〴ぜ〰ぐはばふぬちぴどはのぜ〴〩਼㰠⽓ 䝯呯 䐠⡳畢獥捴楯渮㈮㌩‾㸊⡜㌷㙜㌷㝜〰こぬづづばぜ〴ぜ〰あひづちぴとどのでぜ〴ぜ〰きづちびふひづねづのぴびぜ〴〩਼㰠⽓ 䝯呯 䐠⡳畢獥捴楯渮㈮㐩‾㸊⡜㌷㙜㌷㝜〰ごべばづぜ〴ぜ〰〲ぜ〴ぜ〰いどちぢづぴづびぜ〴ぜ〰ごひづちぴねづのぴぜ〴ぜ〰ちぴぜ〴ぜ〰あちびづぬどのづぜ〴ぜ〰ちのつぜ〴ぜ〰つふひどのでぜ〴ぜ〰ぇぬべっづねどっぜ〴ぜ〰ぉのぴづのびどてどっちぴどはのぜ〴〩਼㰠⽓ 䝯呯 䐠⡳畢獥捴楯渮㈮㔩‾㸊⡜㌷㙜㌷㝜〰こぴちぴどびぴどっちぬぜ〴ぜ〰ぁのちぬべびどびぜ〴〩਼㰠⽓ 䝯呯 䐠⡳散瑩潮⸳ Children: Item: Title: こぴちぴづねづのぴぜ〴ぜ〰はのぜ〴ぜ〰ぅぴとどっびぜ〴〩਼㰠⽓ 䝯呯 䐠⡳畢獥捴楯渮㈮㈩‾㸊⡜㌷㙜㌷㝜〰こぴふつべぜ〴ぜ〰いづびどでのぜ〴ぜ〰ちのつぜ〴ぜ〰いづびっひどばぴどはのぜ〴ぜ〰はてぜ〴ぜ〰ぴとづぜ〴ぜ〰こぴふつべぜ〴ぜ〰ぐはばふぬちぴどはのぜ〴〩਼㰠⽓ 䝯呯 䐠⡳畢獥捴楯渮㈮㌩‾㸊⡜㌷㙜㌷㝜〰こぬづづばぜ〴ぜ〰あひづちぴとどのでぜ〴ぜ〰きづちびふひづねづのぴびぜ〴〩਼㰠⽓ 䝯呯 䐠⡳畢獥捴楯渮㈮㐩‾㸊⡜㌷㙜㌷㝜〰ごべばづぜ〴ぜ〰〲ぜ〴ぜ〰いどちぢづぴづびぜ〴ぜ〰ごひづちぴねづのぴぜ〴ぜ〰ちぴぜ〴ぜ〰あちびづぬどのづぜ〴ぜ〰ちのつぜ〴ぜ〰つふひどのでぜ〴ぜ〰ぇぬべっづねどっぜ〴ぜ〰ぉのぴづのびどてどっちぴどはのぜ〴〩਼㰠⽓ 䝯呯 䐠⡳畢獥捴楯渮㈮㔩‾㸊⡜㌷㙜㌷㝜〰こぴちぴどびぴどっちぬぜ〴ぜ〰ぁのちぬべびどびぜ〴〩਼㰠⽓ 䝯呯 䐠⡳散瑩潮⸳ Item: Title: こぴふつべぜ〴ぜ〰いづびどでのぜ〴ぜ〰ちのつぜ〴ぜ〰いづびっひどばぴどはのぜ〴ぜ〰はてぜ〴ぜ〰ぴとづぜ〴ぜ〰こぴふつべぜ〴ぜ〰ぐはばふぬちぴどはのぜ〴〩਼㰠⽓ 䝯呯 䐠⡳畢獥捴楯渮㈮㌩‾㸊⡜㌷㙜㌷㝜〰こぬづづばぜ〴ぜ〰あひづちぴとどのでぜ〴ぜ〰きづちびふひづねづのぴびぜ〴〩਼㰠⽓ 䝯呯 䐠⡳畢獥捴楯渮㈮㐩‾㸊⡜㌷㙜㌷㝜〰ごべばづぜ〴ぜ〰〲ぜ〴ぜ〰いどちぢづぴづびぜ〴ぜ〰ごひづちぴねづのぴぜ〴ぜ〰ちぴぜ〴ぜ〰あちびづぬどのづぜ〴ぜ〰ちのつぜ〴ぜ〰つふひどのでぜ〴ぜ〰ぇぬべっづねどっぜ〴ぜ〰ぉのぴづのびどてどっちぴどはのぜ〴〩਼㰠⽓ 䝯呯 䐠⡳畢獥捴楯渮㈮㔩‾㸊⡜㌷㙜㌷㝜〰こぴちぴどびぴどっちぬぜ〴ぜ〰ぁのちぬべびどびぜ〴〩਼㰠⽓ 䝯呯 䐠⡳散瑩潮⸳ Item: Title: こぬづづばぜ〴ぜ〰あひづちぴとどのでぜ〴ぜ〰きづちびふひづねづのぴびぜ〴〩਼㰠⽓ 䝯呯 䐠⡳畢獥捴楯渮㈮㐩‾㸊⡜㌷㙜㌷㝜〰ごべばづぜ〴ぜ〰〲ぜ〴ぜ〰いどちぢづぴづびぜ〴ぜ〰ごひづちぴねづのぴぜ〴ぜ〰ちぴぜ〴ぜ〰あちびづぬどのづぜ〴ぜ〰ちのつぜ〴ぜ〰つふひどのでぜ〴ぜ〰ぇぬべっづねどっぜ〴ぜ〰ぉのぴづのびどてどっちぴどはのぜ〴〩਼㰠⽓ 䝯呯 䐠⡳畢獥捴楯渮㈮㔩‾㸊⡜㌷㙜㌷㝜〰こぴちぴどびぴどっちぬぜ〴ぜ〰ぁのちぬべびどびぜ〴〩਼㰠⽓ 䝯呯 䐠⡳散瑩潮⸳ Item: Title: ごべばづぜ〴ぜ〰〲ぜ〴ぜ〰いどちぢづぴづびぜ〴ぜ〰ごひづちぴねづのぴぜ〴ぜ〰ちぴぜ〴ぜ〰あちびづぬどのづぜ〴ぜ〰ちのつぜ〴ぜ〰つふひどのでぜ〴ぜ〰ぇぬべっづねどっぜ〴ぜ〰ぉのぴづのびどてどっちぴどはのぜ〴〩਼㰠⽓ 䝯呯 䐠⡳畢獥捴楯渮㈮㔩‾㸊⡜㌷㙜㌷㝜〰こぴちぴどびぴどっちぬぜ〴ぜ〰ぁのちぬべびどびぜ〴〩਼㰠⽓ 䝯呯 䐠⡳散瑩潮⸳ Item: Title: こぴちぴどびぴどっちぬぜ〴ぜ〰ぁのちぬべびどびぜ〴〩਼㰠⽓ 䝯呯 䐠⡳散瑩潮⸳ Item: Title: げづびふぬぴびぜ〴〩਼㰠⽓ 䝯呯 䐠⡳散瑩潮⸴ Item: Title: いどびっふびびどはのぜ〴〩਼㰠⽓ 䝯呯 䐠⡳散瑩潮⸵ Item: Title: ぃはのっぬふびどはのびぜ〴〩਼㰠⽓ 䝯呯 䐠⡳散瑩潮⸵ Item: Title: げづてづひづのっづび Filters: FilterPipeline: FlateDecode Fonts: Type1: Font: BaseFont: VSHNAE+Rpcxr FontSubset: true FirstChar: 169 LastChar: 169 FontDescriptor: FontName: VSHNAE+Rpcxr Flags: Symbolic FontBBox: -212, -286, 1344, 973 FontFile: true Font: BaseFont: UOCZPF+URWPalladioL-Ital FontSubset: true FirstChar: 2 LastChar: 121 FontDescriptor: FontName: UOCZPF+URWPalladioL-Ital Flags: Symbolic FontBBox: -170, -305, 1010, 941 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: SIDZAU+URWPalladioL-Bold FontSubset: true FirstChar: 3 LastChar: 122 FontDescriptor: FontName: SIDZAU+URWPalladioL-Bold Flags: Symbolic FontBBox: -152, -301, 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