PURPOSE: Obstructive sleep apnea syndrome (OSAS) and diabetes mellitus (DM) are commonly encountered diseases, each associated with a substantial risk of morbidity and mortality. Recent evidence suggests that the presence of OSAS may increase the risk of developing insulin resistance and type 2 DM. The purpose of this study was to test our hypothesis, that OSAS and DM complications are related.
METHODS: The electronic charts of all DM patients referred for sleep studies over a one year period were reviewed. Data collected included patient's age and gender, body mass index, glycosylated hemoglobin A1c (HgA1c), evidence of microalbuminuria, presence of microvascular complications (retinopathy and/or neuropathy), presence of macrovascular complications (coronary artery disease, carotid disease, stroke or transient ischemic attack) and multiple OSAS variables produced by sleep study. Analysis involved examining bivariate associations between OSAS variables and metabolic syndrome parameters.
RESULTS: From a total number of 447 patients who over one year period, 127 patients with DM were identified. AHI (Apnea Hypopnea Index) was directly related to diabetic microvascular complications (p <0.05) and macrovascular complications (p <0.1). The number of hypopneas was also direclty related to microalbuminuria (p <0.1). The number of apneas was significantly related to macrovascular (p <0.1) and microvascular complications (p <0.05). Oxygen saturation was significantly inversely related to microalbumin (p< 0.01), macrovascular complications (p <0.1) and microvascular complications (p <0.05). The average HgA1c in our study group was significantly below the national HgA1c average. HgA1c was not associated with any of the sleep parameters.
CONCLUSION: Despite well controlled DM, as reflected in HgA1c, OSAS was directly related to microalbuminuria, microvascular and macrovascular complications. Although OSAS and type II DM are independent diseases, our study support the hypothesis that OSAS may contribute to DM complications.
CLINICAL IMPLICATIONS: Screening diabetic patients for OSAS should be thought about early on in the work up and management of such population since this might be a potentially treatable cardiovascular risk factor.
DISCLOSURE: Semaan Kosseifi, None.