The Effect Of CPAP Therapy On Glycemic And Lipid Metabolism And Endocrine Function In Patients With OSAHS And Type 2 Diabetes

Obstuctive:To investigate the effect of continuous positive airway pressure (CPAP) therapy on glycemic and lipid metabolism and endocrine function in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) and type 2 diabetes mellitus (T2DM).Methods:To use a continuous glucose monitoring system (CGMS) to measure interstitial glucose in 43 cases of patients with T2DM and newly diagnosed OSAHS, and 3 of them have quit the experiment. The measurements were repeated after an at least 30 days of CPAP treatment. Subsequently, the data of insulin sensitivity, glycohemoglobin (HbAlc), blood pressure (BP), lipid, thyroid hormone, growth hormone (GH), adrenocorticotropic hormone (ACTH), cortisol (COR) and sex hormone were rechecked and compared to the data previously achieved.Results:1.40 cases of all the patients were well tolerated with CPAP, with an average therapy time of 57.03±24.85 d, and daily therapy time of 5.57±1.19 h.2. The Apnea hypopnea index (AHI) of the patients after treatment has been changed comparing with before (p<0.001), without body mass index (BMI) changed.3. After CPAP treatment, the CGMS indicators showed that 24 h and nightime mean blood glucose (MBG) were significantly reduced (p<0.001, p=0.03). The mean ambulatory glucose excursions (MAGE) and mean of daily differences (MODD) were also significantly reduced (p<0.001, p=0.002) compared to pretreatment levels. During the night, MAGE was also significantly decreased (p=0.049). The differences between the highest and lowest levels of blood glucose over 24 h and during the night were significantly lower than before (p<0.001, p=0.024). The 24 h durations of high blood glucose (>7.8 mmol/L and >11.1 mmol/L) were decreased (p＜0.001, p<0.001) after the treatment. And the postprandial blood glucose of meals were decreased (p＜0.001, p＜0.001, p＜0.001).3. HbAlc level was also lower than before treatment (p＜0.001), and the homeostasis model assessment index of insulin resistance (HOMA-IR) was significantly lower than before CPAP treatment (p=0.034), the low density lipoprotein cholesterol (LDL-C) was siginificantly lower than before (p=0.001), the prolactin (PRL) and estradiol (E2) levels of male were significantly lower (p=0.016, p=0.013), without significant changes in other monitoring levels (p>0.05).Conclusions:CPAP can be combined with an overall improvement in blood glucose stability, insulin resistance and part of the lipid in type 2 diabetes patients with OSAHS, which is an effective treatment in addition to lifestyle intervention and drug treatment, but not for other endocrine function in these patients significantly.