Obstructive sleep apnea and diabetes mellitus

Background: there is convincing evidence that obstructive sleep apnea (osa) is highly associated with impaired glucose metabolism. objectives: analyze the prevalence of osa in type 1 and type 2 diabetes mellitus (dm) patients. evaluate the influence of osa on glycemic control. methods: the adult patients with diabetes mellitus (dm) followed in the department of internal medicine were referred to our sleep unit. a home respiratory polygraphy was then performed on all patients with body mass index (bmi) < 40 kg/m2. the glycemic control was assessed by the value of glycated hemoglobin (hba1c) in the previous 3 months. results: a total of 46 patients were studied (20 men and 26 women),the mean age was 50 ± 15 years and mean bmi was 28.6 ± 4.9 kg/m2. the mean hba1c was 8.3 ± 1.2. twenty three patients had type 2 dm and 23 patients had type 1 dm. twenty nine patients (63.0%) had osa and 8.7% had severe osa (ahi > 30/h). the mean ct90 was 5.3 ± 12.5 and the mean ahi was 13.6 ± 18.3. the mean ahi was similar between type 1 and type 2 dm (15.7 ± 24.5 vs 11.6 ± 8.9; p = 0.46). the ahi was not correlated with the bmi. type 2 dm patients with poor glycemic control (hba1c > 7.5%) had a significantly higher mean ahi (14.3 ± 9.0 vs 6.4 ± 6.2; p = 0.038). this difference did not remain significant after adjustment for bmi (p = 0.151). conclusions: the prevalence of osa in type 1 dm is similar to that found in type 2 dm. we note the high prevalence of osa in younger patients with type 1 dm. © 2013 sociedade portuguesa de pneumologia.