Study of Obstructive Sleep Apnea in Obese Patients with Type 2 Diabetes Mellitus

Abstract

ABSTRACT Introduction: Obstructive Sleep Apnea (OSA), characterised by repetitive episodes of breathing cessation due to upper airway collapse is associated with significant morbidity and mortality. Type 2 Diabetes Mellitus (T2DM) and OSA are two common, chronic conditions that are associated with each other, in a bidirectional relationship and both share common risk factor obesity. Aim: To study the prevalence of OSA in obese patients with T2DM. Materials and Methods: Unattended polysomnography was performed in 50 obese (BMI >30 Kg/m2) and T2DM patients (symptoms of diabetes plus random blood glucose concentration ≥200 mg/dL and/or fasting plasma glucose ≥126 mg/dL, and/or Haemoglobin A1c (HbA1c) ≥6.5%, and/or 2-hour plasma glucose ≥200 mg/dL). Descriptive statistical methods were used such as computing percentage, mean, standard deviation and correlations. Results: Over 88% (N=44) of participants i.e., 64% male (N=32) and 24% female (N=12) with obesity and T2DM (Mean HbA1c 8.87±1.88) had OSA with an Apnea-Hypopnea Index (AHI) ≥5 events/h. The mean AHI was 33.57±24.88 events/h in males and 24.33±18.75 events/h in females. A total of 32% (N=16) of the participants had mild OSA (AHI 5-14), 26% (N=13) had moderate OSA (AHI 15-30), and 30% had severe OSA (AHI ≥30) (N=15). 28 out of 34 class I obese (BMI- 30-34.99 kg/m2) with T2DM, 12 out of 12 class II obese (BMI- 35-39.99 kg/m2) with T2DM and 4 out of 4 class III obese (BMI≥40 kg/m2) and T2DM patients had OSA (p-value=0.001). Conclusion: There was an exceedingly high prevalence of undiagnosed OSA in obese patients with T2DM.

Keywords

• apnea-hypopnea index
• bidirectional relationship
• breathing cessation
• polysomnography
• sleep disordered breathing