Author:
Loffler Kelly A.,Heeley Emma,Freed Ruth,Meng Rosie,Bittencourt Lia R.,Carvalho Carolina C. Gonzaga,Chen Rui,Hlavac Michael,Liu Zhihong,Lorenzi-Filho Geraldo,Luo Yuanming,McArdle Nigel,Mukherjee Sutapa,Yap Hooi Shan,Zhang Xilong,Palmer Lyle J.,Anderson Craig S.,McEvoy R. Doug,Drager Luciano F.,investigators SAVE substudy
Abstract
<b>Objective</b><div> <div>Despite evidence
of a relationship between obstructive sleep apnea (OSA), metabolic
dysregulation and diabetes mellitus (DM), it is uncertain whether OSA treatment
can improve metabolic parameters. We sought to determine effects of long-term
continuous positive airway pressure (CPAP) treatment on glycemic control and DM
risk in patients with cardiovascular disease (CVD) and OSA.</div><div><strong>Research
Design and Methods</strong></div><div>Blood, medical history, and personal data were
collected in a substudy of 888 participants in the Sleep Apnea
Cardiovascular Endpoints (SAVE) trial in which patients with OSA and stable CVD
were randomized to receive CPAP plus Usual Care, or Usual Care alone.
Serum glucose and glycated hemoglobin A<sub>1c</sub> (HbA<sub>1c</sub>) were measured
at baseline, and six months, two- and four years, and incident diabetes diagnoses recorded.</div><div><b>Results</b></div><div>Median follow-up was 4.3 years. In those with pre-existing DM (n=274), there
was no significant difference between CPAP and Usual Care groups in serum
glucose, HbA<sub>1c</sub> or anti-diabetic medications during
follow-up. There were also no significant between-group differences in participants
with pre-diabetes (n=452), nor in new diagnoses of DM. Interaction testing suggested
that women with diabetes did poorly in the Usual Care group while their counterparts
on CPAP therapy remained stable.</div><div><strong>Conclusions</strong></div><div>Among patients with established CVD
and OSA, we found no evidence that CPAP therapy over several years affected glycemic
control in those with diabetes or pre-diabetes, or DM risk over standard of
care treatment. The potential differential effect according
to sex deserves further investigation.</div></div>
Publisher
American Diabetes Association
Cited by
2 articles.
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