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

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2020
Author
Gutiérrez Carrasquilla, Liliana
López Cano, Carolina
Sánchez Peña, Enric
Barbé Illa, Ferran
Dalmases, Mireia
Hernández García, Marta
Campos, Angela
Gaeta, Anna Michela
Carmona, Paola
Hernández, Cristina
Simó, Rafael
Lecube Torelló, Albert
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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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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/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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http://hdl.handle.net/10459.1/69586
DOI
https://doi.org/10.3390/jcm9041022
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Journal of Clinical Medicine, 2020, vol. 9, núm. 4, p. 1022
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