Effect of 12‐week continuous positive airway pressure therapy on glucose levels assessed by continuous glucose monitoring in people with type 2 diabetes and obstructive sleep apnoea; a randomized controlled trial

• Published in: Endocrinology, diabetes & metabolism diabetes & metabolism, 2021-04, Vol.4 (2), p.e00148-n/a
• Main Authors: Banghøj, Anne Margareta, Krogager, Christoffer, Kristensen, Peter Lommer, Hansen, Klavs Würgler, Laugesen, Esben, Fleischer, Jesper, Lebech Cichosz, Simon, Poulsen, Per Løgstrup, Glymer Kirkegaard, Martin, Thorsteinsson, Birger, Tarnow, Lise
• Format: Article
• Language: English
• Subjects: Aged; Blood Glucose; Blood Glucose Self-Monitoring; Blood pressure; continuous glucose monitoring; Continuous Positive Airway Pressure; Creatinine; Diabetes; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - complications; Female; Glucose monitoring; Glycated Hemoglobin; Glycemic Control; Humans; Hypoglycemia; Hypoxia; Insulin resistance; Male; Middle Aged; Negative Results; obstructive sleep apnoea; Original; Original s; Peripheral neuropathy; Sensors; Severity of Illness Index; Sleep apnea; Sleep Apnea, Obstructive - blood; Sleep Apnea, Obstructive - complications; Sleep Apnea, Obstructive - therapy; Systematic review; Time Factors; type 2 diabetes
• ISSN: 2398-9238; 2398-9238
• DOI: 10.1002/edm2.148

Aim Obstructive sleep apnoea (OSA) is frequent in type 2 diabetes (T2D). The aim was to investigate the effect of a 12‐week treatment with continuous positive airway pressure (CPAP) on glycaemic control assessed by continuous glucose monitoring (CGM), HbA1c and fasting blood glucose in patients with T2D and newly detected OSA. Methods In a randomized controlled multicentre study, 72 participants with T2D and moderate to severe OSA (78% male, age 62 ± 7, AHI 35 ± 15) were recruited from outpatient clinics in three Danish hospitals and were randomized to CPAP intervention or control. The main outcome was glycaemic control assessed by 6 days CGM at baseline and after 12‐week therapy, as well as by HbA1c and fasting blood glucose. Results No significant changes were found in average glucose levels, time in glucose range, time with hypoglycaemia, time with hyperglycaemia or coefficient of variability. HbA1c decreased 0.7 mmol/mol (0.07%; P = .8) in the CPAP group and increased 0.8 mmol/mol (0.08%; P = .6) in the control group (intergroup difference, P = .6). Fasting blood glucose increased by 0.2 mmol/L (P = .02) in the CPAP group and by 0.4 mmol/L (P = .01) in the control group (intergroup difference, P = .7). In a prespecified subgroup analysis comparing participants with high adherence (minimum usage of four hours/night for 70% of all nights) to CPAP to the control group, no significant changes were observed either, although these participants had a tendency towards better glycaemic indices. Conclusions CPAP treatment for 12 weeks does not significantly change glycaemic control in patients with type 2 diabetes and OSA. Former studies show a high prevalence of obstructive sleep apnoea (OSA) in people with type 2 diabetes (T2D). Previous data are divergent on whether continuous positive airway pressure (CPAP) therapy improves glycaemic control in people with T2D and OSA. In this randomized controlled study, no effect was found of 12‐week CPAP treatment on glycaemic control measured by continuous glucose monitoring, HbA1c and fasting blood glucose. This study does not support implementation of routine CPAP to people with T2D and OSA with the purpose of improving glycaemic control.