title: The Effect of Treatment of Obstructive Sleep Apnea on Glycemic Control in Type 2 Diabetes.
abstract: There is uncertainty about the effects of treating obstructive sleep apnea on glycemic control in patients with type 2 diabetes.
  
  
  
  To determine whether treatment of obstructive sleep apnea in patients with type 2 diabetes improves glycemic control.
  
  
  
  In this trial, we randomized patients with type 2 diabetes and no previous diagnosis of obstructive sleep apnea, with a glycated hemoglobin level of 6.5-8.5%, and an oxygen desaturation index of 15 or more events per hour to positive airway pressure therapy or to usual care.
  
  
  
  A total of 416 patients met the entry criteria as determined by each site and were randomized. Of the 298 participants who met centrally adjudicated entry criteria, no differences between the study groups were seen for change in glycated hemoglobin. Furthermore, there were no between-group differences when analyses were restricted to those with poorer baseline glycemic control, those with more severe sleep apnea, or those who were adherent to therapy. A greater fall in diastolic blood pressure occurred in the positive airway pressure group than in the usual care group (-3.5 mm Hg vs. -1.5 mm Hg; P = 0.07). This difference was significant in those who were adherent to positive airway pressure therapy (-4.4 mm Hg vs. -1.6 mm Hg; P = 0.02). There was a significant reduction in sleepiness in the positive airway pressure therapy group (P < 0.0001). Quality of life assessment revealed improvements in vitality, mental health, and mental component summary scores in the positive airway pressure therapy group.
  
  
  
  This trial showed no effect of positive airway pressure therapy on glycemic control in patients with relatively well-controlled type 2 diabetes and obstructive sleep apnea. Clinical trial registered with www.clinicaltrials.gov (NCT00509223).
authors.affiliation: 1 Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia.
authors.forename: Jonathan E
authors.identifier: 0000-0002-6187-2203
authors.initials: JE
authors.lastname: Shaw
authors.affiliation: 2 Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Naresh M
authors.initials: NM
authors.lastname: Punjabi
authors.affiliation: 3 Alfred Hospital and Monash University, Melbourne, Victoria, Australia.
authors.forename: Matthew T
authors.initials: MT
authors.lastname: Naughton
authors.affiliation: 4 Willes Consulting Group, Inc., Encinitas, California.
authors.forename: Leslee
authors.initials: L
authors.lastname: Willes
authors.affiliation: 5 International Diabetes Center, Park Nicollet Clinic, Minneapolis, Minnesota.
authors.forename: Richard M
authors.initials: RM
authors.lastname: Bergenstal
authors.affiliation: 6 Department of Respiratory and Sleep Medicine and.
authors.forename: Peter A
authors.initials: PA
authors.lastname: Cistulli
authors.affiliation: 7 Department of Endocrinology, Royal North Shore Hospital and University of Sydney, Sydney, New South Wales, Australia; and.
authors.forename: Greg R
authors.initials: GR
authors.lastname: Fulcher
authors.affiliation: 8 ResMed Science Center, ResMed Ltd, Sydney, New South Wales, Australia.
authors.forename: Glenn N
authors.initials: GN
authors.lastname: Richards
authors.affiliation: 1 Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia.
authors.forename: Paul Z
authors.initials: PZ
authors.lastname: Zimmet
mesh_terms: D001315:Australia; D001786:Blood Glucose / Q000378:metabolism*; D015897:Comorbidity; D045422:Continuous Positive Airway Pressure; D003924:Diabetes Mellitus, Type 2 / Q000628:therapy*; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D009656:North America; D020181:Sleep Apnea, Obstructive / Q000628:therapy*
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin
keywords: diabetes mellitus; glycemic control; positive airway pressure therapy; sleep-disordered breathing