title: Association between obstructive sleep apnea severity and glucose control in patients with untreated versus treated diabetes.
abstract: The purpose of this study was to determine whether the association between obstructive sleep apnea severity and glucose control differs between patients with newly diagnosed and untreated type 2 diabetes, and patients with known and treated type 2 diabetes. This multicentre cross-sectional study included 762 patients investigated by sleep recording for suspected obstructive sleep apnea, 497 of whom were previously diagnosed and treated for type 2 diabetes (treated diabetic patients), while 265 had no medical history of diabetes but had fasting blood glucose ≥126 mg dL(-1) and/or glycated haemoglobin (HbA1c ) ≥6.5% consistent with newly diagnosed type 2 diabetes (untreated diabetic patients). Multivariate regression analyses were performed to evaluate the independent association between HbA1c and obstructive sleep apnea severity in treated and untreated patients with diabetes. In untreated diabetic patients, HbA1c was positively associated with apnea-hypopnea index (P = 0.0007) and 3% oxygen desaturation index (P = 0.0016) after adjustment for age, gender, body mass index, alcohol habits, metabolic dyslipidaemia, hypertension, statin use and study site. The adjusted mean value of HbA1c increased from 6.68% in the lowest quartile of the apnea-hypopnea index (<17) to 7.20% in the highest quartile of the apnea-hypopnea index (>61; P = 0.033 for linear trend). In treated patients with diabetes, HbA1c was associated with non-sleep variables, including age, metabolic dyslipidaemia and insulin use, but not with obstructive sleep apnea severity. Obstructive sleep apnea may adversely affect glucose control in patients with newly diagnosed and untreated type 2 diabetes, but may have a limited impact in patients with overt type 2 diabetes receiving anti-diabetic medications.
authors.affiliation: Département de Pneumologie, Université d'Angers, CHU, Angers, France.|INSERM U1063, Angers, France.
authors.forename: Pascaline
authors.initials: P
authors.lastname: Priou
authors.affiliation: CERMES, CNRS UMR8211-INSERM U988-EHESS, Villejuif, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Le Vaillant
authors.affiliation: Département de Pneumologie, Université d'Angers, CHU, Angers, France.|INSERM U1063, Angers, France.
authors.forename: Nicole
authors.initials: N
authors.lastname: Meslier
authors.affiliation: Service d'Explorations Fonctionnelles, Hôpital Laennec, Nantes, France.
authors.forename: Sylvaine
authors.initials: S
authors.lastname: Chollet
authors.affiliation: Unité de Pneumologie, Pôle santé des Olonnes, Olonne sur Mer, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: Pigeanne
authors.affiliation: Service de Pneumologie, Centre Hospitalier, Cholet, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Masson
authors.affiliation: Service de Pneumologie, Centre Hospitalier, La Roche sur Yon, France.
authors.forename: Acya
authors.initials: A
authors.lastname: Bizieux-Thaminy
authors.affiliation: Pneumologie, Nouvelles Cliniques Nantaises, Nantes, France.
authors.forename: Marie-Pierre
authors.initials: MP
authors.lastname: Humeau
authors.affiliation: Service de Pneumologie, Centre Hospitalier, Le Mans, France.
authors.forename: François
authors.initials: F
authors.lastname: Goupil
authors.affiliation: INSERM U1063, Angers, France.|Departement d'Endocrinologie, Diabetologie, Nutrition, CHU, Angers, France.
authors.forename: Pierre-Henri
authors.initials: PH
authors.lastname: Ducluzeau
authors.affiliation: Département de Pneumologie, Université d'Angers, CHU, Angers, France.|INSERM U1063, Angers, France.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Gagnadoux
mesh_terms: D001786:Blood Glucose / Q000032:analysis / Q000378:metabolism*; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000628:therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D017286:Polysomnography; D012720:Severity of Illness Index; D012890:Sleep; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000503:physiopathology*
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D010100:Oxygen
keywords: diabetes; glycated haemoglobin; intermittent hypoxia; obstructive sleep apnea