Continuous Positive Airway Pressure Treatment, Glycemia, and Diabetes Risk in Obstructive Sleep Apnea and Comorbid Cardiovascular Disease

Apr 16, 2020Diabetes care

Continuous Positive Airway Pressure, Blood Sugar, and Diabetes Risk in People with Sleep Apnea and Heart Disease

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Abstract

No significant difference was observed in glycemic control or diabetes risk between CPAP treatment and usual care over a median follow-up of 4.3 years in patients with cardiovascular disease and obstructive sleep apnea.

In patients with preexisting diabetes, serum glucose and glycated hemoglobin levels showed no significant change between CPAP and usual care groups.
Participants with prediabetes also exhibited no significant differences in glycemic control or new diabetes diagnoses between treatment groups.
Interaction tests indicated that women with diabetes on usual care did not maintain stability in their condition, unlike those receiving CPAP therapy.
Findings suggest that long-term CPAP therapy does not improve glycemic control or reduce diabetes risk in this patient population.

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OBJECTIVE: Despite evidence of a relationship among obstructive sleep apnea (OSA), metabolic dysregulation, and diabetes, it is uncertain whether OSA treatment can improve metabolic parameters. We sought to determine effects of long-term continuous positive airway pressure (CPAP) treatment on glycemic control and diabetes risk in patients with cardiovascular disease (CVD) and OSA.

RESEARCH DESIGN AND METHODS: Blood, medical history, and personal data were collected in a substudy of 888 participants in the Sleep Apnea cardioVascular Endpoints (SAVE) trial in which patients with OSA and stable CVD were randomized to receive CPAP plus usual care, or usual care alone. Serum glucose and glycated hemoglobin A(HbA) were measured at baseline, 6 months, and 2 and 4 years and incident diabetes diagnoses recorded. 1c1c

RESULTS: Median follow-up was 4.3 years. In those with preexisting diabetes (= 274), there was no significant difference between the CPAP and usual care groups in serum glucose, HbA, or antidiabetic medications during follow-up. There were also no significant between-group differences in participants with prediabetes (= 452) or new diagnoses of diabetes. Interaction testing suggested that women with diabetes did poorly in the usual care group, while their counterparts on CPAP therapy remained stable. n n1c

CONCLUSIONS: Among patients with established CVD and OSA, we found no evidence that CPAP therapy over several years affects glycemic control in those with diabetes or prediabetes or diabetes risk over standard-of-care treatment. The potential differential effect according to sex deserves further investigation.

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Continuous Positive Airway Pressure Treatment, Glycemia, and Diabetes Risk in Obstructive Sleep Apnea and Comorbid Cardiovascular Disease

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