What has sleep apnea got to do with diabetes? A lot, says a new study, demonstrating a link between obstructive sleep apnea (OSA) and the development of diabetes.
The largest study to date of the relationship between sleep apnea and diabetes involving 8,678 Canadian patients has confirmed earlier evidence of such a relationship from smaller studies with shorter follow-up periods.
"Our study, with a median follow-up of 67 months was able to address some of the limitations of earlier studies on the connection between OSA and diabetes," said lead author Tetyana Kendzerska from the University of Toronto.
The researchers found that among patients with OSA, the initial severity of the disease predicted the subsequent risk for incident diabetes.
The study analysed 8,678 adults with suspected OSA without diabetes at baseline who underwent a diagnostic sleep study between 1994 and 2010 and were followed through May 2011.
Patients were classified as not having OSA (AHI < 5), or having mild (AHI 5-14.9), moderate (AHI 15-30) or severe (AHI > 30) OSA.
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During follow-up, 1,017 (11.7 percent) patients developed diabetes.
Patients with an apnea-hypopnea index (AHI) greater than 30 had a 30 percent higher risk of developing diabetes than those with an AHI less than 5.
Patients with mild or moderate OSA had a 23 percent increased risk of developing diabetes.
"After adjusting for other potential causes, we were able to demonstrate a significant association between OSA severity and the risk of developing diabetes," Kendzerska maintained.
"Our findings that prolonged oxygen desaturation, shorter sleep time and higher heart rate were associated with diabetes are consistent with the pathophysiological mechanisms thought to underlie the relationship between OSA and diabetes," he stated.
The findings were published online in the American Thoracic Society's American Journal of Respiratory and Critical Care Medicine.