Hypoxemia and glycemic control in type 2 diabetes mellitus with extreme obesity

Wen Bun Leong, Dev Banerjee, Melissa Nolen, Peymané Adab, G. Neil Thomas, Shahrad Taheri

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Context: Obstructive sleep apnea (OSA) has been shown to be associated with type 2 diabetes mellitus (DM). Studies on healthy individuals found that OSA is associated with lower insulin sensitivity. We hypothesized that nocturnal hypoxemia from OSA is associated with poorer glycemia in severely obese DM individuals. Copyright

Design and Setting: This was a retrospective observational study of 122 non-DM, 126 non-insulintreated DM, and 35 insulin-treated DM patients. Data were collected on demographic characteristics, body mass index, and comorbidities. An overnight sleep study was performed in all patients, and OSA was defined as an apnea-hypopnea index of ≥5 events/h.

Results: There were more males (P = .003) and a lower proportion of white Europeans (P = .010) among DM patients. The prevalence of OSA was 80.1% in DM and 63.1% in non-DM individuals (P = .001). DM individuals also had lower oxygen saturation (O2) (P = .0106), greater percentage of time spent under 90% oxygen saturation (%TST<90%) (P = .0067), and higher apnea-hypopnea index (P = .0085). Regression analysis showed that %TST<90% and minimum O2 saturations were associatedwithworsehemoglobinA1c resultsamongDMindividuals.Every10%reductioninminimum O2wasassociatedwitha0.3%increase inHbA1c,whereasa10%increase in%TST<90%wasassociated with a 0.2% increase in hemoglobin A1c after adjusting for a range of potential confounders.

Conclusion: The high OSA prevalence in DM individuals and a positive relationship between nocturnal hypoxemia and glycemia supports the need to assess correction of hypoxemia as a management strategy for glycemic control.

Original languageEnglish
Pages (from-to)E1650-E1654
JournalJournal of Clinical Endocrinology and Metabolism
Volume99
Issue number9
DOIs
Publication statusPublished - 1 Sep 2014

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Medical problems
Type 2 Diabetes Mellitus
Obstructive Sleep Apnea
Diabetes Mellitus
Obesity
Apnea
Oxygen
Insulin
Hypoxia
Observational Studies
Sleep
Insulin Resistance
Comorbidity
Regression analysis
Hemoglobins
Body Mass Index
Retrospective Studies
Regression Analysis
Demography

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Biochemistry
  • Endocrinology
  • Clinical Biochemistry
  • Biochemistry, medical

Cite this

Hypoxemia and glycemic control in type 2 diabetes mellitus with extreme obesity. / Leong, Wen Bun; Banerjee, Dev; Nolen, Melissa; Adab, Peymané; Thomas, G. Neil; Taheri, Shahrad.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 99, No. 9, 01.09.2014, p. E1650-E1654.

Research output: Contribution to journalArticle

Leong, Wen Bun ; Banerjee, Dev ; Nolen, Melissa ; Adab, Peymané ; Thomas, G. Neil ; Taheri, Shahrad. / Hypoxemia and glycemic control in type 2 diabetes mellitus with extreme obesity. In: Journal of Clinical Endocrinology and Metabolism. 2014 ; Vol. 99, No. 9. pp. E1650-E1654.
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T1 - Hypoxemia and glycemic control in type 2 diabetes mellitus with extreme obesity

AU - Leong, Wen Bun

AU - Banerjee, Dev

AU - Nolen, Melissa

AU - Adab, Peymané

AU - Thomas, G. Neil

AU - Taheri, Shahrad

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N2 - Context: Obstructive sleep apnea (OSA) has been shown to be associated with type 2 diabetes mellitus (DM). Studies on healthy individuals found that OSA is associated with lower insulin sensitivity. We hypothesized that nocturnal hypoxemia from OSA is associated with poorer glycemia in severely obese DM individuals. CopyrightDesign and Setting: This was a retrospective observational study of 122 non-DM, 126 non-insulintreated DM, and 35 insulin-treated DM patients. Data were collected on demographic characteristics, body mass index, and comorbidities. An overnight sleep study was performed in all patients, and OSA was defined as an apnea-hypopnea index of ≥5 events/h.Results: There were more males (P = .003) and a lower proportion of white Europeans (P = .010) among DM patients. The prevalence of OSA was 80.1% in DM and 63.1% in non-DM individuals (P = .001). DM individuals also had lower oxygen saturation (O2) (P = .0106), greater percentage of time spent under 90% oxygen saturation (%TST<90%) (P = .0067), and higher apnea-hypopnea index (P = .0085). Regression analysis showed that %TST<90% and minimum O2 saturations were associatedwithworsehemoglobinA1c resultsamongDMindividuals.Every10%reductioninminimum O2wasassociatedwitha0.3%increase inHbA1c,whereasa10%increase in%TST<90%wasassociated with a 0.2% increase in hemoglobin A1c after adjusting for a range of potential confounders.Conclusion: The high OSA prevalence in DM individuals and a positive relationship between nocturnal hypoxemia and glycemia supports the need to assess correction of hypoxemia as a management strategy for glycemic control.

AB - Context: Obstructive sleep apnea (OSA) has been shown to be associated with type 2 diabetes mellitus (DM). Studies on healthy individuals found that OSA is associated with lower insulin sensitivity. We hypothesized that nocturnal hypoxemia from OSA is associated with poorer glycemia in severely obese DM individuals. CopyrightDesign and Setting: This was a retrospective observational study of 122 non-DM, 126 non-insulintreated DM, and 35 insulin-treated DM patients. Data were collected on demographic characteristics, body mass index, and comorbidities. An overnight sleep study was performed in all patients, and OSA was defined as an apnea-hypopnea index of ≥5 events/h.Results: There were more males (P = .003) and a lower proportion of white Europeans (P = .010) among DM patients. The prevalence of OSA was 80.1% in DM and 63.1% in non-DM individuals (P = .001). DM individuals also had lower oxygen saturation (O2) (P = .0106), greater percentage of time spent under 90% oxygen saturation (%TST<90%) (P = .0067), and higher apnea-hypopnea index (P = .0085). Regression analysis showed that %TST<90% and minimum O2 saturations were associatedwithworsehemoglobinA1c resultsamongDMindividuals.Every10%reductioninminimum O2wasassociatedwitha0.3%increase inHbA1c,whereasa10%increase in%TST<90%wasassociated with a 0.2% increase in hemoglobin A1c after adjusting for a range of potential confounders.Conclusion: The high OSA prevalence in DM individuals and a positive relationship between nocturnal hypoxemia and glycemia supports the need to assess correction of hypoxemia as a management strategy for glycemic control.

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