Effect of dapagliflozin on obstructive sleep apnea in patients with type 2 diabetes: a preliminary study

Abstract

ObjectiveThe aim of this case-control study was to assess the efficacy of dapagliflozin combined with metformin for type-2 diabetes mellitus (T2DM) with obstructive sleep apnea hypopnea syndrome (OSAHS).MethodsA total of 36 patients with newly-diagnosed T2DM and OSAHS were randomized divided into two groups. Eighteen OSAHS patients with T2DM, who were treated with dapagliflozin and metformin, were assigned as the dapagliflozin group. These patients were given dapagliflozin and metformin for 24 weeks between February 2017 and February 2018. Another 18 OSAHS patients with T2DM, who were treated with glimepiride and metformin for 24 weeks, were assigned as the control group. Fasting plasma glucose (FPG) level, postprandial blood glucose (PPG), hemoglobin A1C (HbA1c), fasting insulin, homeostasis model assessment of insulin resistance (HOMA-IR), blood lipids, body mass index (BMI), blood pressure, apnea-hypopnea index (AHI), minimum oxygen saturation (LSpO2), and Epworth Somnolence Scale (ESS) score were measured before and at 24 weeks after the initiation of treatment.ResultsIn the dapagliflozin group, triglyceride (TG), systolic pressure (SBP) and diastolic pressure (DBP) significantly decreased following treatment, while high-density lipoprotein cholesterol (HDL-C) significantly increased (P < 0.05). Furthermore, a reduction in AHI, an increase in LSpO2 and a decrease in ESS score were observed in the dapagliflozin group (P < 0.05), but not in the control group. Moreover, blood glucose, HbA1c, HOMA-IR, and BMI significantly decreased in these two groups, and the decrease was more significant in the dapagliflozin group.ConclusionThese present results indicate that dapagliflozin can significantly reduce glucose, BMI, blood pressure and AHI, and improve hypoxemia during sleep and excessive daytime sleepiness, which thereby has potential as an effective treatment approach for OSAHS.

Sleep disorders in people with type 2 diabetes and associated health outcomes: a review of the literature

“…One study examined the effect of type 2 diabetes medication associated with weight loss on OSA in type 2 diabetes [ 62 ]. This RCT in 36 individuals investigated the effect of dapagliflozin, a sodium–glucose cotransporter 2 (SGLT2) inhibitor.…”

Basic and Clinical Pharmaco-Therapeutics of SGLT2 Inhibitors: A Contemporary Update

“…improved insulin sensitivity) remain pleiotropic effects of SGLT2 inhibitors, but not primary indicative benefits. Other conditions associated with increased weight, including polycystic ovarian disease or obstructive sleep apnoea, may also benefit from SGLT2 inhibitors in certain patients [57,59,60]. The present evidence, although limited in several aspects, does suggest clinically meaningful propositions of SGLT2 inhibitors that are worthy of further evaluation.…”

Effect of Glucose Improvement on Nocturnal Sleep Breathing Parameters in Patients with Type 2 Diabetes: The Candy Dreams Study

“…However, this amelioration in AHI was closely related with weight loss. Similarly, a reduction in AHI and an increase in minimum SaO 2 were detected in newly diagnosed patients with type 2 diabetes and OSA who were treated for 24 weeks with dapagliflozine, a sodium glucose co-transporter 2 inhibitor, but not in the placebo group [30]. Our study has tried to minimize the beneficial effect of weight loss on nighttime breathing by excluding those patients who experienced a significant reduction in their BMI between the baseline study and the end of the follow-up.…”