Prevalence of obstructive sleep apnoea in men with type 2 diabetes

West, Sophie; Nicoll, D; Stradling, John

doi:10.1136/thx.2005.057745

Cited by 333 publications

(263 citation statements)

References 28 publications

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“…38 People with diabetes are at higher risk of coronary artery disease and congestive heart failure, which may contribute to the development of atrial fibrillation. Finally, after accounting for obesity, people with diabetes have higher prevalence of obstructive sleep apnea, 39 which may lead to atrial fibrillation. 40 Our study has limitations.…”

Section: Discussionmentioning

confidence: 99%

Diabetes Mellitus, Glycemic Control, and Risk of Atrial Fibrillation

et al. 2010

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BACKGROUND: Diabetes may be an independent risk factor for atrial fibrillation. However, results from prior studies are in conflict, and no study has examined diabetes duration or glycemic control. OBJECTIVE: To examine the association of diabetes with risk of atrial fibrillation and to describe risk according to diabetes duration and glycemic control. DESIGN: A population-based case-control study. PARTICIPANTS: Within a large, integrated healthcare delivery system, we identified 1,410 people with newlyrecognized atrial fibrillation from ICD-9 codes and validated cases by review of medical records. 2,203 controls without atrial fibrillation were selected from enrollment lists, stratified on age, sex, hypertension, and calendar year. MAIN MEASURES: Information on atrial fibrillation, diabetes and other characteristics came from medical records. Diabetes was defined based on physician diagnoses recorded in the medical record, and pharmacologically treated diabetes was defined as receiving antihyperglycemic medications. Information about hemoglobin A1c levels came from computerized laboratory data. KEY RESULTS: Among people with atrial fibrillation, 252/1410 (17.9%) had pharmacologically treated diabetes compared to 311/2203 (14.1%) of controls. The adjusted OR for atrial fibrillation was 1.40 (95% CI 1.15-1.71) for people with treated diabetes compared to those without diabetes. Among those with treated diabetes, the risk of developing atrial fibrillation was 3% higher for each additional year of diabetes duration (95% CI 1-6%). Compared to people without diabetes, the adjusted OR for people with treated diabetes with average hemoglobin A1c ≤7 was 1.06 (95% CI 0.74-1.51); for A1c >7 but ≤8, 1.48 (1.09-2.01); for A1c >8 but ≤9, 1.46 (1.02-2.08); and for A1c >9, 1.96 (1.22-3.14). CONCLUSIONS: Diabetes was associated with higher risk of developing atrial fibrillation, and risk was higher with longer duration of treated diabetes and worse glycemic control. Future research should identify and test approaches to reduce the risk of atrial fibrillation in people with diabetes.

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Section: Discussionmentioning

confidence: 99%

Diabetes Mellitus, Glycemic Control, and Risk of Atrial Fibrillation

et al. 2010

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“…Obstructive sleep apnea (OSA) is very common in patients with type 2 diabetes (T2D) (6)(7)(8)(9)(10). We previously reported that OSA is associated with peripheral neuropathy, nephropathy, and estimated glomerular filtration rate decline in patients with T2D independently of obesity (10,11).…”

mentioning

confidence: 99%

Obstructive Sleep Apnea and Retinopathy in Patients with Type 2 Diabetes. A Longitudinal Study

Altaf

Dodson

Ali

et al. 2017

Am J Respir Crit Care Med

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Rationale: Obstructive sleep apnea (OSA) is associated with several pathophysiological deficits found in diabetic retinopathy (DR). Hence, it's plausible that OSA could play a role in the pathogenesis of sight-threatening DR (STDR).Objectives: To assess the relationship between OSA and DR in patients with type 2 diabetes and to assess whether OSA is associated with its progression.Methods: A longitudinal study was conducted in diabetes clinics within two U.K. hospitals. Patients known to have any respiratory disorder (including OSA) were excluded. DR was assessed using twofield 45-degree retinal images for each eye. OSA was assessed using a home-based multichannel cardiorespiratory device. Measurements and Main Results:A total of 230 patients were included. STDR and OSA prevalence rates were 36.1% and 63.9%, respectively. STDR prevalence was higher in patients with OSA than in those without OSA (42.9% vs. 24.1%; P = 0.004). After adjustment for confounders, OSA remained independently associated with STDR (odds ratio, 2.3; 95% confidence interval, 1.1-4.9; P = 0.04). After a median (interquartile range) follow-up of 43.0 (37.0-51.0) months, patients with OSA were more likely than patients without OSA to develop preproliferative/proliferative DR (18.4% vs. 6.1%; P = 0.02). After adjustment for confounders, OSA remained an independent predictor of progression to preproliferative/proliferative DR (odds ratio, 5.2; 95% CI confidence interval, 1.2-23.0; P = 0.03). Patients who received continuous positive airway pressure treatment were significantly less likely to develop preproliferative/proliferative DR.Conclusions: OSA is associated with STDR in patients with type 2 diabetes. OSA is an independent predictor for the progression to preproliferative/proliferative DR. Continuous positive airway pressure treatment was associated with reduction in preproliferative/proliferative DR. Interventional studies are needed to assess the impact of OSA treatment on STDR.

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“…27 Patients with mild reduction in arterial hemoglobin saturation due to sleep apnoea have more severe retinopathy than those whose airways do no obstruct at night. Positive pressure ventilation in such patients also reduces the rate of progression of DR. [28][29][30][31][32] Does illuminating the retina reduce the risk of progression of retinopathy?…”

Section: Evidence That Oxygen Supplementation Improves Visual Functiomentioning

confidence: 99%

Spare the rods and spoil the retina: revisited

Sivaprasad

Arden

2015

Eye

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Visual function improves with oxygen inhalation in people with diabetes even in the absence of visible retinopathy. Rods consume the most oxygen in the retina due to the high metabolic activity required to maintain the dark current. Therefore, Arden hypothesized that in diabetes where oxygen supply may also be affected due to the changes in retinal vasculature, prevention of dark adaptation may be a viable option to prevent or decrease the rate of progression of diabetic retinopathy. Animal experiments have proven that the absence of rods decreases the development of retinal neovascularisation. The same principle applies to panretinal photocoagulation, an established treatment for proliferative diabetic retinopathy. Recently, a few clinical studies have also shown that preventing dark adaptation by suppressing rods with 500-nm light source at night decreases the rate of progression of early diabetic retinopathy and maculopathy in the short-term. We await the results of a large two-year multi-centre trial (CLEOPATRA trial) to evaluate the long-term effects of decreasing dark adaptation by applying a 500-nm light source as a mask over eyes with non-central diabetic macular oedema.

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Prevalence of obstructive sleep apnoea in men with type 2 diabetes

Cited by 333 publications

References 28 publications

Diabetes Mellitus, Glycemic Control, and Risk of Atrial Fibrillation

Diabetes Mellitus, Glycemic Control, and Risk of Atrial Fibrillation

Obstructive Sleep Apnea and Retinopathy in Patients with Type 2 Diabetes. A Longitudinal Study

Spare the rods and spoil the retina: revisited

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