Can PAP Therapy for OSA Improve Glycemic Metrics?

By Patrick Zakka, MD - Last Updated: April 19, 2023

Researchers, led by R. Nisha Aurora, MD, MHS, cited glycemic variability is linked to increased cardiovascular disease risk among patients with type 2 diabetes, regardless of glycosylated hemoglobin (HbA1c) levels. Additionally, studies on positive airway pressure (PAP) therapy for obstructive sleep apnea (OSA) have produced inconsistent findings regarding its effects on HbA1c levels.

Dr. Aurora and colleagues sought to determine if PAP therapy improved glycemic variability in patients with moderate-to-severe OSA and type 2 diabetes. Overall, they reported PAP therapy did not appear to improve glycemic control or variability in this patient population. The study was presented in Chest.

PAP Therapy Did Not Improve Glycemic Measures

The authors’ randomized controlled trial enrolled 184 patients with type 2 diabetes and OSA . Participants were randomized to lifestyle counseling with or without PAP therapy for 3 months. The primary end points were standard deviation of glucose levels, additional continuous glucose monitoring (CGM) values, and self-monitored blood glucose.

According to the report, the cohort’s average use of PAP therapy was 5.4 ± 1.6 hours per night. Overall, researchers found no significant differences between the 2 groups for any primary or secondary CGM end points; however, exploratory analyses found some differences.

Specifically, PAP therapy in women was associated with glucose levels standard deviation improvements, with a mean between-group difference of 3.5 mg/dl (P=.02). Additionally, PAP therapy was associated with lower post-dinner (20.1 mg/dl; P<.01) and post-bedtime (34.6 mg/dl; P<.01) glucose levels compared with patients not on PAP.

Ultimately, the study’s authors concluded that PAP therapy did not improve glycemic variability or control in patients with moderate-to-severe OSA and type 2 diabetes, although exploratory findings may warrant additional investigation.

Related: CPAP for Obstructive Sleep Apnea: Impact on Cognition

Post Tags:obstructive sleep apneatype 2 diabetes
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