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Preliminary evidence that obese patients with obstructive sleep apnea/hypopnea syndrome are refractory to the acute beneficial metabolic effects of a very low calorie diet.

Abstract
Since obesity seems to play a causal role in both obstructive sleep apnea/hypopnea syndrome (OSAHS) and type 2 diabetes, the question arises whether diet-induced weight loss is equally efficacious in type 2 diabetic patients with and without OSAHS. The present study was aimed to investigate the effect of 1 week very low calorie diet (VLCD) on oxygen desaturation index (ODI) and on glucose regulation in OSAHS versus non-OSAHS patients. Fourteen patients with type 2 diabetes mellitus and morbid obesity were enrolled. According to ODI, patients were divided into 2 groups (with and without OSAHS) and evaluated by a hyperglycemic clamp study, before and after a 7 day-VLCD. After a VLCD, a significant reduction of anthropometric parameters, in the overall group and in subgroups, was observed. M-value and acute insulin response increased significantly only in patients without obstructive sleep apnea (990.10 ± 170.19 vs. 1,205.22 ± 145.73 μmol min(-1) m(-2), p = 0.046; -1.05 ± 8.40 vs. 48.26 ± 11. 90 pmol/L, p = 0.028, respectively). The average 24-h heart rate (24-h HR) fell significantly (p = 0.05), primarily because of a decrease during daytime (p = 0.041), in the whole group. In conclusion, we observed that morbidly obese patients with type 2 diabetes and OSAHS are specifically resistant to the acute beneficial effects of VLCD on metabolic parameters. Our preliminary observation deserves further investigation to clarify the pathogenetic mechanisms involved.
AuthorsIlaria Giordani, Ilaria Malandrucco, Fabiana Picconi, Susanna Longo, Alessandra Di Flaviani, Laura Chioma, Barbara Moscatelli, Silvia Donno, Simona Frontoni
JournalActa diabetologica (Acta Diabetol) Vol. 50 Issue 4 Pg. 639-43 (Aug 2013) ISSN: 1432-5233 [Electronic] Germany
PMID23740164 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Topics
  • Caloric Restriction
  • Diabetes Mellitus, Type 2 (diet therapy, metabolism)
  • Female
  • Humans
  • Male
  • Middle Aged
  • Obesity (diet therapy, metabolism)
  • Sleep Apnea, Obstructive (diet therapy, metabolism)

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