title: Effect of one week of CPAP treatment of obstructive sleep apnoea on 24-hour profiles of glucose, insulin and counter-regulatory hormones in type 2 diabetes.
abstract: Studies examining the impact of CPAP treatment on glycaemic control have yielded conflicting results, partly because of insufficient nightly CPAP use. We examined the 24-hour profiles of glucose, insulin and counter-regulatory hormones in 12 subjects with type 2 diabetes and OSA before and after 1 week of effective in-laboratory CPAP therapy over an entire 8-hour night thus ensuring optimal CPAP compliance. Blood samples were collected every 15 to 30 minutes for 24 hours under controlled conditions. The 24-hour mean glucose decreased from 153.2 ± 33.0 to 139.7 ± 24.2 mg/dL with CPAP (-13.5 ± 13.5 mg/dL; P = .005) without change in insulin levels. Morning fasting glucose levels decreased by 14.6 ± 3 mg/dL (P = .001) and the dawn phenomenon decreased by 7.8 ± 9.8 mg/dL (P = .019). CPAP treatment decreased norepinephrine levels while the 24-hour profiles of growth hormone and cortisol remained unchanged. In conclusion, 1 week of effective treatment of OSA over an entire 8-hour night results in a clinically significant improvement in glycaemic control via an amelioration of evening fasting glucose metabolism and a reduction in the dawn phenomenon, a late-night glucose increase that is not adequately treated by oral medications. Clinical Trials Information: ClinicalTrials.gov Identifier: NCT01136785.
authors.affiliation: Section of Pulmonary and Critical Care, Department of Medicine, Sleep Disorders Center, University of Chicago, Chicago, Illinois.|Department of Medicine, Sleep, Metabolism and Health Center, University of Chicago, Chicago, Illinois.
authors.forename: Babak
authors.initials: B
authors.lastname: Mokhlesi
authors.affiliation: Department of Medicine, Sleep, Metabolism and Health Center, University of Chicago, Chicago, Illinois.
authors.forename: Daniela
authors.initials: D
authors.lastname: Grimaldi
authors.affiliation: Department of Medicine, Sleep, Metabolism and Health Center, University of Chicago, Chicago, Illinois.
authors.forename: Guglielmo
authors.initials: G
authors.lastname: Beccuti
authors.affiliation: Department of Medicine, Sleep, Metabolism and Health Center, University of Chicago, Chicago, Illinois.|Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Chicago, Chicago, Illinois.
authors.forename: Eve
authors.initials: E
authors.lastname: Van Cauter
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D045422:Continuous Positive Airway Pressure; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000378:metabolism*; D005215:Fasting; D005260:Female; D019382:Human Growth Hormone / Q000378:metabolism; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism; D007328:Insulin / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009638:Norepinephrine / Q000378:metabolism; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000378:metabolism / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D007328:Insulin; D019382:Human Growth Hormone; D006854:Hydrocortisone; D009638:Norepinephrine
keywords: OSA; adherence; compliance; continuous positive airway pressure; glucose metabolism; glycaemic control; sleep apnea; type 2 diabetes