title: Treatment with continuous positive airway pressure may affect blood glucose levels in nondiabetic patients with obstructive sleep apnea syndrome.
abstract: OBJECTIVE
  Obstructive sleep apnea syndrome (OSAS) is often associated with impaired glucose metabolism. Data on the effects of OSAS treatment with continuous positive airway pressure (CPAP) on blood glucose and insulin resistance are conflicting. The study aimed at assessing the immediate effect of CPAP on glucose control measured with a continuous glucose monitoring system (CGMS).
  
  
  METHODS
  Nine non-diabetes subjects with OSAS (mean age 53.0 +/- 8.0 years; body mass index 34.8 +/- 5.3 kg/m2) underwent 2 overnight polysomnographic examinations: a diagnostic study and one with CPAP treatment. Continuous glucose monitoring system (CGMS) was applied overnight on both occasions. Glucose metabolism was assessed with a 75-g oral glucose tolerance test, plasma insulin and homeostatic model assessment of insulin resistance (HOMA-IR) index.
  
  
  RESULTS
  The mean (+/- SD) apnoea-hypopnea index (AHI) at diagnostic polysomnography was 54.3 +/- 29.3 (range 16-81). Fasting plasma insulin levels in patients with OSAS was 84.3 +/- 43.4 pM at baseline, and the HOMA-IR was 3.6 +/- 2.2. CPAP treatment in the subjects with OSAS resulted in a significant reduction in the AHI to 4.5 +/- 7.1. All of the major saturation parameters improved significantly on CPAP. CGMS showed mean glucose values significantly higher during the CPAP night than during the diagnostic night: 80 +/- 11 mg/dL versus 63 +/- 7 mg/dL (P < .01). Fasting insulin and HOMA-IR measured after the CPAP night tended to be higher than at baseline (98.4 +/- 51.0 pmol vs 84.3 +/- 43.4 pmol and 3.9 pmol +/- 2.6 vs 3.6 +/- 2.2 pmol, respectively, P > .05).
  
  
  CONCLUSIONS
  CPAP treatment in nondiabetic obese patients with OSAS may have an immediate elevating effect on blood glucose.
authors.affiliation: Department of Diabetology and Metabolic Diseases, Medical University of Lodz, Barlicki University Hospital No 1, ul. Kopcinskiego 22, 90-153, Lodz, Poland. bigosik@poczta.onet.pl
authors.forename: Leszek
authors.initials: L
authors.lastname: Czupryniak
authors.forename: Jerzy
authors.initials: J
authors.lastname: Loba
authors.forename: Maciej
authors.initials: M
authors.lastname: Pawlowski
authors.forename: Dariusz
authors.initials: D
authors.lastname: Nowak
authors.forename: Piotr
authors.initials: P
authors.lastname: Bialasiewicz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000378:metabolism*; D015992:Body Mass Index; D045422:Continuous Positive Airway Pressure / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D020181:Sleep Apnea, Obstructive / Q000097:blood* / Q000628:therapy*
chemical_list: D001786:Blood Glucose