Effect of CPAP on insulin resistance and HbA1c in men with obstructive sleep apnoea and type 2 diabetes.

BACKGROUND: The effects of continuous positive airway pressure (CPAP) for obstructive sleep apnoea (OSA) on insulin resistance are not clear. Trials have found conflicting results and no appropriate control groups have been used. METHODS: Forty-two men with known type 2 diabetes and newly diagnosed...

Full description

Bibliographic Details
Main Authors: West, S, Nicoll, D, Wallace, T, Matthews, DR, Stradling, JR
Format: Journal article
Language:English
Published: 2007
_version_ 1797081208566317056
author West, S
Nicoll, D
Wallace, T
Matthews, DR
Stradling, JR
author_facet West, S
Nicoll, D
Wallace, T
Matthews, DR
Stradling, JR
author_sort West, S
collection OXFORD
description BACKGROUND: The effects of continuous positive airway pressure (CPAP) for obstructive sleep apnoea (OSA) on insulin resistance are not clear. Trials have found conflicting results and no appropriate control groups have been used. METHODS: Forty-two men with known type 2 diabetes and newly diagnosed OSA (>10 dips/h in oxygen saturation of >4%) were randomised to receive therapeutic (n = 20) or placebo CPAP (n = 22) for 3 months. Baseline tests were performed and repeated after 3 months. The study was double blind. RESULTS: Results are expressed as mean (SD). CPAP improved the Epworth sleepiness score significantly more in the therapeutic group than in the placebo group (-6.6 (4.5) vs -2.6 (4.9), p = 0.01). The maintenance of wakefulness test improved significantly in the therapeutic group but not in the placebo group (+10.6 (13.9) vs -4.7 (11.8) min, p = 0.001). Glycaemic control and insulin resistance did not significantly change in either the therapeutic or placebo groups: HbA1c (-0.02 (1.5) vs +0.1 (0.7), p = 0.7, 95% CI -0.6% to +0.9%), euglycaemic clamp (M/I: +1.7 (14.1) vs -5.7 (14.8), p = 0.2, 95% CI -1.8 to +0.3 l/kg/min(1000)), HOMA-%S (-1.5 (2.3) vs -1.1 (1.8), p = 0.2, 95% CI -0.3% to +0.08%) and adiponectin (-1.1 (1.2) vs -1.1 (1.3), p = 0.2, 95% CI -0.7 to +0.6 microg/ml). Body mass index, bioimpedance and anthropometric measurements were unchanged. Hours of CPAP use per night were 3.6 (2.8) in the treatment group and 3.3 (3.0) in the placebo group (p = 0.8). There was no correlation between CPAP use and the measures of glycaemic control or insulin resistance. CONCLUSION: Therapeutic CPAP does not significantly improve measures of glycaemic control or insulin resistance in men with type 2 diabetes and OSA.
first_indexed 2024-03-07T01:11:19Z
format Journal article
id oxford-uuid:8d1bbbc0-decb-4a2c-a7de-1c3a43ec71cc
institution University of Oxford
language English
last_indexed 2024-03-07T01:11:19Z
publishDate 2007
record_format dspace
spelling oxford-uuid:8d1bbbc0-decb-4a2c-a7de-1c3a43ec71cc2022-03-26T22:49:06ZEffect of CPAP on insulin resistance and HbA1c in men with obstructive sleep apnoea and type 2 diabetes.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:8d1bbbc0-decb-4a2c-a7de-1c3a43ec71ccEnglishSymplectic Elements at Oxford2007West, SNicoll, DWallace, TMatthews, DRStradling, JR BACKGROUND: The effects of continuous positive airway pressure (CPAP) for obstructive sleep apnoea (OSA) on insulin resistance are not clear. Trials have found conflicting results and no appropriate control groups have been used. METHODS: Forty-two men with known type 2 diabetes and newly diagnosed OSA (>10 dips/h in oxygen saturation of >4%) were randomised to receive therapeutic (n = 20) or placebo CPAP (n = 22) for 3 months. Baseline tests were performed and repeated after 3 months. The study was double blind. RESULTS: Results are expressed as mean (SD). CPAP improved the Epworth sleepiness score significantly more in the therapeutic group than in the placebo group (-6.6 (4.5) vs -2.6 (4.9), p = 0.01). The maintenance of wakefulness test improved significantly in the therapeutic group but not in the placebo group (+10.6 (13.9) vs -4.7 (11.8) min, p = 0.001). Glycaemic control and insulin resistance did not significantly change in either the therapeutic or placebo groups: HbA1c (-0.02 (1.5) vs +0.1 (0.7), p = 0.7, 95% CI -0.6% to +0.9%), euglycaemic clamp (M/I: +1.7 (14.1) vs -5.7 (14.8), p = 0.2, 95% CI -1.8 to +0.3 l/kg/min(1000)), HOMA-%S (-1.5 (2.3) vs -1.1 (1.8), p = 0.2, 95% CI -0.3% to +0.08%) and adiponectin (-1.1 (1.2) vs -1.1 (1.3), p = 0.2, 95% CI -0.7 to +0.6 microg/ml). Body mass index, bioimpedance and anthropometric measurements were unchanged. Hours of CPAP use per night were 3.6 (2.8) in the treatment group and 3.3 (3.0) in the placebo group (p = 0.8). There was no correlation between CPAP use and the measures of glycaemic control or insulin resistance. CONCLUSION: Therapeutic CPAP does not significantly improve measures of glycaemic control or insulin resistance in men with type 2 diabetes and OSA.
spellingShingle West, S
Nicoll, D
Wallace, T
Matthews, DR
Stradling, JR
Effect of CPAP on insulin resistance and HbA1c in men with obstructive sleep apnoea and type 2 diabetes.
title Effect of CPAP on insulin resistance and HbA1c in men with obstructive sleep apnoea and type 2 diabetes.
title_full Effect of CPAP on insulin resistance and HbA1c in men with obstructive sleep apnoea and type 2 diabetes.
title_fullStr Effect of CPAP on insulin resistance and HbA1c in men with obstructive sleep apnoea and type 2 diabetes.
title_full_unstemmed Effect of CPAP on insulin resistance and HbA1c in men with obstructive sleep apnoea and type 2 diabetes.
title_short Effect of CPAP on insulin resistance and HbA1c in men with obstructive sleep apnoea and type 2 diabetes.
title_sort effect of cpap on insulin resistance and hba1c in men with obstructive sleep apnoea and type 2 diabetes
work_keys_str_mv AT wests effectofcpaponinsulinresistanceandhba1cinmenwithobstructivesleepapnoeaandtype2diabetes
AT nicolld effectofcpaponinsulinresistanceandhba1cinmenwithobstructivesleepapnoeaandtype2diabetes
AT wallacet effectofcpaponinsulinresistanceandhba1cinmenwithobstructivesleepapnoeaandtype2diabetes
AT matthewsdr effectofcpaponinsulinresistanceandhba1cinmenwithobstructivesleepapnoeaandtype2diabetes
AT stradlingjr effectofcpaponinsulinresistanceandhba1cinmenwithobstructivesleepapnoeaandtype2diabetes