EASD: Chronic intermittent hypoxia induced by sleep apnea could contribute to the progression of microvascular complications in T2DM
as presented at the annual meeting of the European Association for the Study of Diabetes
A study presented at EASD, held in September in Vienna, suggests that chronic intermittent hypoxia induced by sleep apnea could contribute to the progression of microvascular complications in type 2 diabetes.
Researchers at the Hôpital Cardiologique Louis Pradel, Bron, France, and colleagues performed a retrospective observational study of 68 type 2 diabetic patients with obstructive sleep apnea syndrome (OSAS). Respiratory parameters of obstructive sleep apnea and occurrence of diabetes complications were reported between diagnosis of sleep apnea and a mean follow-up of four years.
Participants had high cardiovascular risk and most presented a severe OSAS (73%). Mean nocturnal oxygen saturation and time spent with oxygen saturation <90% were significantly impaired in presence of microvascular complications compared to absence of microvascular complications (90% vs 93% and 29% vs 7%, respectively, P <0.005). According to the researchers, using logistic regression analysis the occurrence of long-term microvascular complications was independently associated with hypoxemia indexes (odds ratio [OR] 0.69; P=0.007), regardless of adherence to CPAP therapy, age, sex, BMI, HbA1C, and diabetes duration. Diabetic nephropathy was predicted both by hypoxemia indexes and diabetes duration. However, no correlation was found between apnea hypopnea index (AHI) and any diabetes complications. Optimal adherence to CPAP therapy did not improve metabolic parameters or prevent microvascular complications. However, myocardial infarctions were more prevalent in subjects with weak adherence to CPAP therapy (+17% vs. +9%; P=0,03).
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