Abstract
Introduction: Patients with obstructive sleep apnea (OSA) are at increased risk of developing metabolic disease such as diabetes mellitus. Positive airway pressure (PAP) therapy is the gold standard treatment for OSA. Although PAP effectively reduces apneas, the effects of such treatment on comorbidities such as type 2 diabetes mellitus (DM) is not sufficiently clarified. The objective of our study was to assess the effect of PAP treatment on the glycemic control in OSA patients.
Method: Glycated hemoglobin (HbA1c) was assessed in sample of patients of the European Sleep Apnea Database (ESADA) [n=1608, 13 centres, 74.2% males, mean age 53.9±10.8, body mass index (BMI) 32.8±7.0 and apnea hypopnea index (AHI) 40.4±24.5] at baseline and following PAP therapy (>90 days).
Results: Hb1Ac was reduced at follow-up from 5.98±1.01% to 5.93±0.98% (p=0.001, mean treatment duration 378.9±423.0 days). Subsequently, HbA1c decrease was more pronounced in diabetic patients (-0.152±1.022, p=0.019), severe OSA patients (-0.097±0.678, p=0.005), morbidly obese patients (-0.1989±0.81446, p<0.001), and patients using auto-PAP (-0.115±0.709, p=0.030). HbA1c change was most pronounced in patients with weight reduction >5 kilos at follow-up (-0.379±0.988, p<0.001). In regression analysis, severe OSA (p=0.038), morbid obesity (p=0.005), auto-PAP therapy (p<0.001), and weight reduction >5 kilos (p<0.001) were independently associated with HbA1c reduction.
Conclusion: Overall, HbA1c reduction with PAP therapy was limited but a clinically relevant reduction was achieved in severe OSA and in those morbidly obese and who lost weight.
Footnotes
Cite this article as: European Respiratory Journal 2019; 54: Suppl. 63, PA2007.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2019