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Article: CPAP therapy for patients with sleep apnea and type 2 diabetes mellitus improves control of blood pressure

TitleCPAP therapy for patients with sleep apnea and type 2 diabetes mellitus improves control of blood pressure
Authors
KeywordsObstructive sleep apnea
Type 2 diabetes mellitus
HbA1c
Blood pressure
CPAP therapy
Issue Date2017
PublisherSpringer Verlag. The Journal's web site is located at http://www.springer.com/medicine/internal/journal/11325
Citation
Sleep and Breathing, 2017, v. 21 n. 2, p. 377-386 How to Cite?
AbstractPURPOSE: Obstructive sleep apnea (OSA) is highly associated with type 2 diabetes mellitus (DM), and treatment of OSA may have a positive impact on cardiometabolic profile. This study investigates the effects of continuous positive airway pressure (CPAP) treatment on glycemic control and cardiometabolic parameters in patients with diabetes. METHODS: Diabetic patients, who were newly diagnosed of OSA with an apnea hypopnea index (AHI) ≥15 and HbA1c ≥7%, were randomly assigned to either CPAP treatment or no treatment (control) for 3 months. Measurements included HbA1c, blood pressure, fasting glucose and lipids, urinary albumin, and peripheral arterial tonometry (to assess endothelial function). RESULTS: Sixty-four patients (52 men) were randomized, with mean (±SD) age of 55.0 ± 9.6 years, body mass index of 29.9 ± 5.3 kg/m2, HbA1c of 8.1 ± 1.1%, and AHI of 45.3 ± 23.2 events/h. In the intention-to-treat analysis, no significant change in HbA1c but reduction of systolic (10 mmHg (-18 to -2), p < 0.05) and diastolic (6 mmHg (-11 to -1), p < 0.05) blood pressures were found in the CPAP group compared to the control group. Excluding those with medication changes or initiated dietary program during the study period and those who dropped out, CPAP treatment decreased HbA1c (intervention group, n = 27; control group, n = 26) by 0.4% (-0.7 to -0.1), p = 0.027. CONCLUSIONS: In patients with type 2 DM and moderate to severe OSA, 3 months of CPAP therapy did not decrease HbA1c but lowered systolic and diastolic blood pressures. In view of a potentially limited effect size of CPAP treatment on glycemic control, sample size estimation for future randomized controlled studies must make adequate allowance for influence from external factors of medications/diet and CPAP use.
Persistent Identifierhttp://hdl.handle.net/10722/242228
ISSN
2020 Impact Factor: 2.816
2020 SCImago Journal Rankings: 0.907
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLam, JCM-
dc.contributor.authorLai, AYK-
dc.contributor.authorTam, TCC-
dc.contributor.authorYuen, MMA-
dc.contributor.authorLam, KSL-
dc.contributor.authorIp, MSM-
dc.date.accessioned2017-07-24T01:37:00Z-
dc.date.available2017-07-24T01:37:00Z-
dc.date.issued2017-
dc.identifier.citationSleep and Breathing, 2017, v. 21 n. 2, p. 377-386-
dc.identifier.issn1520-9512-
dc.identifier.urihttp://hdl.handle.net/10722/242228-
dc.description.abstractPURPOSE: Obstructive sleep apnea (OSA) is highly associated with type 2 diabetes mellitus (DM), and treatment of OSA may have a positive impact on cardiometabolic profile. This study investigates the effects of continuous positive airway pressure (CPAP) treatment on glycemic control and cardiometabolic parameters in patients with diabetes. METHODS: Diabetic patients, who were newly diagnosed of OSA with an apnea hypopnea index (AHI) ≥15 and HbA1c ≥7%, were randomly assigned to either CPAP treatment or no treatment (control) for 3 months. Measurements included HbA1c, blood pressure, fasting glucose and lipids, urinary albumin, and peripheral arterial tonometry (to assess endothelial function). RESULTS: Sixty-four patients (52 men) were randomized, with mean (±SD) age of 55.0 ± 9.6 years, body mass index of 29.9 ± 5.3 kg/m2, HbA1c of 8.1 ± 1.1%, and AHI of 45.3 ± 23.2 events/h. In the intention-to-treat analysis, no significant change in HbA1c but reduction of systolic (10 mmHg (-18 to -2), p < 0.05) and diastolic (6 mmHg (-11 to -1), p < 0.05) blood pressures were found in the CPAP group compared to the control group. Excluding those with medication changes or initiated dietary program during the study period and those who dropped out, CPAP treatment decreased HbA1c (intervention group, n = 27; control group, n = 26) by 0.4% (-0.7 to -0.1), p = 0.027. CONCLUSIONS: In patients with type 2 DM and moderate to severe OSA, 3 months of CPAP therapy did not decrease HbA1c but lowered systolic and diastolic blood pressures. In view of a potentially limited effect size of CPAP treatment on glycemic control, sample size estimation for future randomized controlled studies must make adequate allowance for influence from external factors of medications/diet and CPAP use.-
dc.languageeng-
dc.publisherSpringer Verlag. The Journal's web site is located at http://www.springer.com/medicine/internal/journal/11325-
dc.relation.ispartofSleep and Breathing-
dc.subjectObstructive sleep apnea-
dc.subjectType 2 diabetes mellitus-
dc.subjectHbA1c-
dc.subjectBlood pressure-
dc.subjectCPAP therapy-
dc.titleCPAP therapy for patients with sleep apnea and type 2 diabetes mellitus improves control of blood pressure-
dc.typeArticle-
dc.identifier.emailLam, JCM: lamcmj@hku.hk-
dc.identifier.emailLai, AYK: agneslai@hku.hk-
dc.identifier.emailYuen, MMA: mmayuen@hku.hk-
dc.identifier.emailLam, KSL: ksllam@hku.hk-
dc.identifier.emailIp, MSM: msmip@hku.hk-
dc.identifier.authorityLai, AYK=rp02579-
dc.identifier.authorityLam, KSL=rp00343-
dc.identifier.authorityIp, MSM=rp00347-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1007/s11325-016-1428-7-
dc.identifier.pmid27817148-
dc.identifier.scopuseid_2-s2.0-84994304144-
dc.identifier.hkuros273620-
dc.identifier.volume21-
dc.identifier.issue2-
dc.identifier.spage377-
dc.identifier.epage386-
dc.identifier.isiWOS:000400006800019-
dc.publisher.placeGermany-
dc.identifier.issnl1520-9512-

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