A total of 65 cases of patients with T2DM who were newly diagnosed by oral
glucose tolerance test (OGTT) were enrolled from April 2014 to April 2015 in Gansu Provincial Hospital, and divided into simple T2DM group (
n=30) and
OSAHS with T2DM group (n=35) according to aponea-hypopnea index (AHI) which was monitored by polysomnography (PSG). Their general clinical data were collected, and
glucose level of different periods was monitored by continuous
glucose moitoring system (CGMS). Changes of
glucose level were compared between two groups before and after CPAP treatment.
RESULTS: Age, gender proportion, BMI, smoking and drinking history,
glycosylated hemoglobin (HbA1c) and blood
lipid profile had no significantly difference between two groups. Longer neck circumstance and higher waist-hip ration (WHR), higher systolic blood pressure and diastolic blood pressure, higher fasting plasma
glucose (FPG) [(9.4 ± 3.2) vs (7.3 ± 2.1) mmol/L, P=0.028] and fasting
insulin (FINS) [(19.2 ± 8.7) vs (11.1 ± 4.7) mU/L, P=0.044] level, more serious homeostasis model assessment
insulin resistance (HOMA-IR) were found in
OSAHS patients with T2DM when compared to patients in simple T2DM group. The average dynamic
glucose level of 24 hours, daytime, nocturnal and sleep time in
OSAHS with T2DM group were higher than that in the simple T2DM group (all P<0.05). The alarming times when the average dynamic
glucose level of nocturnal time was more than 0.1 mmol·L⁻¹·min⁻¹ in T2DM with
OSAHS was more than that in control group (P=0.001).
After treatment of CPAP, the level of AHI [(5.9 ± 3.6) vs (56.7 ± 11.4) times/h, P<0.001], average dynamic
glucose level of 24 hours, day, nocturnal and sleep time were obviously decreased (all P<0.05); lowest saturation oxygen (LSpO₂) was significantly increased [(92.3 ± 3.7)% vs (81.5 ± 20.2)%, P<0.001]; the alarming times and HOMA-IR were obviously decreased (P=0.019, 0.043). According to multiple linear regression analysis, the AHI (β=0.736, P<0.001) in
OSAHS with T2DM group was positively related to the average dynamic
glucose level during sleep time, but the LSpO₂(β=-0.889, P<0.001) was negatively correlated.
CONCLUSIONS:
OSAHS patients with newly diagnosed T2DM have higher
glucose level than that in simple T2DM patients, and CPAP
therapy can obviously decrease the
glucose level in newly diagnosed T2DM patients with
OSAHS. AHI and LSpO₂may influence the average dynamic
glucose level during sleep time.