Effect of Glucose Improvement on Nocturnal Sleep Breathing Parameters in Patients with Type 2 Diabetes: The Candy Dreams Study

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2020Author
Gutiérrez Carrasquilla, Liliana
López Cano, Carolina
Dalmases, Mireia
Campos, Angela
Gaeta, Anna Michela
Carmona, Paola
Hernández, Cristina
Simó, Rafael
Suggested citation
Gutiérrez Carrasquilla, Liliana;
López Cano, Carolina;
Sánchez Peña, Enric;
Barbé Illa, Ferran;
Dalmases, Mireia;
Hernández García, Marta;
...
Lecube Torelló, Albert.
(2020)
.
Effect of Glucose Improvement on Nocturnal Sleep Breathing Parameters in Patients with Type 2 Diabetes: The Candy Dreams Study.
Journal of Clinical Medicine, 2020, vol. 9, núm. 4, p. 1022.
https://doi.org/10.3390/jcm9041022.
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Show full item recordAbstract
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.
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Journal of Clinical Medicine, 2020, vol. 9, núm. 4, p. 1022European research projects
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