Sunday, July 4, 2010

Is CPAP a Therapy for Type 2 Diabetes?




How Does Apnea Effect Diabetes?

A number of studies demonstrate that between 18 and 36% of Diabetic patients have Sleep Disordered Breathing (Snoring andSleep Apnea). Sleep Disordered Breathing results in intermittent hypoxia and sleep fragmentation, which is a cause of insulin resistance and excessive sympathetic nervous system activity.

Can CPAP Really Lower Glucose Levels?

Researchers from the Scripps Clinic in La JollaCalifornia studied a group of twenty DM patients recently diagnosed with Sleep Apnea. They continually measured BG levels with and without CPAP therapy in a sleep laboratory. The use of CPAP led to an average BG drop from 122mg/dL to 102.9mg/dL (p=0.03).
The findings show that successful CPAP therapy reduces hyperglycemia and stabilizes Blood Glucose during sleep. As a measure of this stability, the median Standard Deviation of sleeping BG markedly decreased from 20 to 13 (p=0.005) after CPAP.

A Call to Screen All Diabetics

As the authors of the study indicate, variability of BG levels is an independent risk factor for mortality and blindness in DM. Much can be gained with effective therapy for Snoring and Sleep Apnea.
CPAP is the most common therapy for SDB. It involves wearing a nasal mask during sleep which is attached by a long flexible hose to a PAP machine. The researchers suggest that physicians screen all DM patients for SDB, and treat SDB as a means of DM management as well as a strategy for disease prevention.

1. Dawson, A. et al. (2008). CPAP Therapy of Obstructive Sleep Apnea in Type 2 Diabetics Improves Glycemic Control During Sleep. Journal of Clinical Sleep Medicine, Vol. 4(6); 538-542.

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