Effect of Glucose Improvement on Nocturnal Sleep Breathing Parameters in Patients with Type 2 Diabetes : The Candy Dreams Study
Gutiérrez-Carrasquilla, Liliana (Institut de Recerca Biomèdica de Lleida)
López-Cano, Carolina (Institut de Recerca Biomèdica de Lleida)
Sánchez, Enric (Institut de Recerca Biomèdica de Lleida)
Barbé, Ferran (Centro de Investigación Biomédica en Red de Enfermedades Respiratorias)
Dalmases, Mireia (Centro de Investigación Biomédica en Red de Enfermedades Respiratorias)
Hernández, Marta (Institut de Recerca Biomèdica de Lleida)
Campos, Angela (Institut de Recerca Biomèdica de Lleida)
Gaeta, Anna Michaela (Universitat de Lleida)
Carmona, Paola (Universitat de Lleida)
Hernández, Cristina (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Simó Canonge, Rafael (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Lecube, Albert (Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas)
Universitat Autònoma de Barcelona

Date:	2020
Abstract:	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/m 2 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 (R 2 = 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.
Grants:	Ministerio de Economía y Competitividad PI12/00803 Ministerio de Economía y Competitividad PI15/00260 Instituto de Salud Carlos III PI18/00964
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Diabetes ; Apnea ; Hypoxia ; Glycated hemoglobin
Published in:	Journal of clinical medicine, Vol. 9 (april 2020) , ISSN 2077-0383

DOI: 10.3390/jcm9041022
PMID: 32260419

12 p, 683.1 KB

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