Type 2 diabetes, glycemic control, and continuous positive airway pressure in obstructive sleep apnea
Type 2 diabetes, glycemic control, and continuous positive airway pressure in obstructive sleep apnea
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DOI：
10.1001/archinte.165.4.447
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发表时间：
2005-02-28
影响因子：
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通讯作者：
Mazzone, T
中科院分区：
文献类型：
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作者：
Babu, AR;Herdegen, J;Mazzone, T
背景资料：睡眠呼吸障碍（SDB）是一种与显著合并症相关的常见疾病，包括高血压、肥胖、心血管疾病和胰岛素抵抗。胰岛素抵抗的严重程度与SDB的严重程度有关。方法：采用72小时动态血糖监测系统，对25例2型糖尿病患者在持续气道正压通气（CPAP）治疗SDB前后的间质葡萄糖水平和血红蛋白A（1c）水平的变化进行了研究。平均+/-SD CPAP治疗期为83 ± 50天，早餐时的平均+/- SD餐后1小时血糖值显著降低（191 68 rng/dL至130 +/- 41 mg/dL [ 10.6 +/-3.8 mmol/L至7.2 +/-2.3 mmol/L]），午餐（1.96 70 mg/dL至138 49 mg/dL [10.9 +/-3.9 mmol/L至7.7 +/-2.7 mmol/L]）和晚餐（199 +/-66 mg/dL至137 +/-48 mg/dL [11.0 +/-3.7 mmol/L至7.6 +/-2.7 mmol/L]）。在基线血红蛋白A（1c）水平大于7%的17例患者中，血红蛋白A水平显著降低（9.2% +/-2.0%至8.6% +/-1.8%）。此外，在使用CPAP超过4小时/天的受试者中，血红蛋白A1水平的降低与CPAP使用天数显著相关。有没有这样的相关性，在受试者使用CPAP为4小时/d或更少。结论：这些研究结果表明，SDB是病理生理相关的糖稳态受损，CPAP可以是一个重要的治疗方法，糖尿病患者SDB。
Background: Sleep-disordered breathing (SDB) is a prevalent condition associated with significant comorbidities, including hypertension, obesity, cardiovascular disease, and insulin resistance. It has been previously shown that the severity of insulin resistance is related to the severity of SDB.Methods: Using a 72-hour continuous glucose monitoring system, we studied changes in interstitial glucose levels and measured hemoglobin A(1c) levels in 25 patients with type 2 diabetes mellitus before and after continuous positive airway pressure (CPAP) treatment for SDB.Results: With a mean +/-SD CPAP treatment period of 83 50 days, the mean +/- SD 1 -hour postprandial glucose values were significantly reduced for breakfast (191 68 rng/dL to 130 +/- 41 mg/dL [ 10.6 +/-3.8 mmol/L to 7.2 +/-2.3 mmol/L]), lunch (1,96 70 mg/dL to 138 49 mg/dL [10.9 +/-3.9 mmol/L to 7.7 +/-2.7 mmol/L]), and dinner (199 +/-66mg/dLto 137 +/-48mg/dL [11.0 +/-3.7mmoVLto 7.6 +/-2.7 mmol/LJ). In the 17 patients with a baseline hemoglobin A(1c), level greater than 7%, there was a significant reduction in hemoglobin A, level (9.2% +/-2.0% to 8.6% +/-1.8%). Furthermore, in subjects who used CPAP for more than 4 h/d, the reduction in hemoglobin A, level was significantly correlated with days of CPAP use. There was no such correlation in subjects who used CPAP for 4 h/d or less.Conclusions: These findings suggest that SDB is pathophysiologically related to impaired glucose homeostasis, and that CPAP can be an important therapeutic approach for diabetic patients with SDB.