title: Effect of Continuous Positive Airway Pressure on Glycemic Control in Patients with Obstructive Sleep Apnea and Type 2 Diabetes. A Randomized Clinical Trial.
abstract: Obstructive sleep apnea (OSA) is a risk factor for type 2 diabetes that adversely impacts glycemic control. However, there is little evidence about the effect of continuous positive airway pressure (CPAP) on glycemic control in patients with diabetes.
  
  
  
  To assess the effect of CPAP on glycated hemoglobin (HbA1c) levels in patients with suboptimally controlled type 2 diabetes and OSA, and to identify its determinants.
  
  
  
  In a 6-month, open-label, parallel, and randomized clinical trial, 50 patients with OSA and type 2 diabetes and two HbA1c levels equal to or exceeding 6.5% were randomized to CPAP (n = 26) or no CPAP (control; n = 24), while their usual medication for diabetes remained unchanged.
  
  
  
  HbA1c levels, Homeostasis Model Assessment and Qualitative Insulin Sensitivity Check Index scores, systemic biomarkers, and health-related quality of life were measured at 3 and 6 months. After 6 months, the CPAP group achieved a greater decrease in HbA1c levels compared with the control group. Insulin resistance and sensitivity measurements (in noninsulin users) and serum levels of IL-1β, IL-6, and adiponectin also improved in the CPAP group compared with the control group after 6 months. In patients treated with CPAP, mean nocturnal oxygen saturation and baseline IL-1β were independently related to the 6-month change in HbA1c levels (r(2) = 0.510, P = 0.002).
  
  
  
  Among patients with suboptimally controlled type 2 diabetes and OSA, CPAP treatment for 6 months resulted in improved glycemic control and insulin resistance compared with results for a control group. Clinical trial registered with www.clinicaltrials.gov (NCT01801150).
authors.affiliation: 1 Servicio de Neumología.|2 Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Madrid, Spain.
authors.forename: Elisabet
authors.initials: E
authors.lastname: Martínez-Cerón
authors.affiliation: 3 Servicio de Endocrinología, and.
authors.forename: Beatriz
authors.initials: B
authors.lastname: Barquiel
authors.affiliation: 4 Centro de Salud José Marvá, Madrid, Spain.
authors.forename: Ana-Maria
authors.initials: AM
authors.lastname: Bezos
authors.affiliation: 1 Servicio de Neumología.|2 Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Madrid, Spain.
authors.forename: Raquel
authors.initials: R
authors.lastname: Casitas
authors.affiliation: 1 Servicio de Neumología.|2 Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Madrid, Spain.
authors.forename: Raúl
authors.initials: R
authors.lastname: Galera
authors.affiliation: 5 Centro de Salud El Puerto, Coslada, Madrid, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: García-Benito
authors.affiliation: 6 Servicio de Bioquímica, Hospital Universitario La Paz, Madrid, Spain.
authors.forename: Angel
authors.initials: A
authors.lastname: Hernanz
authors.affiliation: 7 Servicio de Neumología, Hospital Universitario Son Espases, Palma de Mallorca, Spain; and.
authors.forename: Alberto
authors.initials: A
authors.lastname: Alonso-Fernández
authors.affiliation: 1 Servicio de Neumología.|2 Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Madrid, Spain.|8 Universidad Autónoma de Madrid, Madrid, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Garcia-Rio
mesh_terms: D001786:Blood Glucose / Q000378:metabolism*; D015897:Comorbidity; D045422:Continuous Positive Airway Pressure; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology / Q000628:therapy*
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin
keywords: clinical trial; diabetes; glycemia; insulin; sleep apnea