More Complications Seen With Comorbid Apnea

SALT LAKE CITY — Obstructive sleep apnea in patients with well-controlled type 2 diabetes appears to be associated with increased risk of diabetic complications, Dr. Semaan G. Kosseifi said at the annual meeting of the American College of Chest Physicians.

This finding suggests there is merit in routine early screening of diabetic patients for obstructive sleep apnea (OSA). It's possible—although as yet unproven—that treating OSA in diabetic patients will prevent or slow progression of diabetic macrovascular complications, thereby reducing the level of cardiovascular risk, according to Dr. Kosseifi of the Quillen College of Medicine, Johnson City, Tenn.

He presented a retrospective observational study involving 127 patients with well-controlled type 2 diabetes who were referred for sleep studies. Their mean age was 61 years, with a mean hemoglobin A1c of 6.5%. Fifty-six percent had microalbuminuria, and 35% had microvascular complications. Thirty-eight percent had severe OSA.

Severity of OSA as reflected by the apnea-hypopnea index showed a powerfully significant direct relationship to diabetic microvascular and macrovascular complications as well as to microalbuminuria. Moreover, oxygen saturation as measured during sleep studies was inversely related to each of these diabetic complications.

HbA1c level within the favorable range present in the study population wasn't associated with OSA.

“Although obstructive sleep apnea and type 2 diabetes are independent diseases, our study supports the hypothesis that obstructive sleep apnea may contribute to diabetic complications,” the physician concluded.