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.