Underdiagnosis of obstructive sleep apnoea syndrome in patients with type 2 diabetes in France: ENTRED 2007

• Published in: Diabetes & metabolism 2013-04, Vol.39 (2), p.139-147
• Main Authors: Lecomte, P, Criniere, L, Fagot-Campagna, A, Druet, C, Fuhrman, C
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Apnées du sommeil; Biological and medical sciences; Comorbidity; Cross-Sectional Studies; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - epidemiology; Diabetes. Impaired glucose tolerance; Diabète de type 2; Educational Status; Endocrine pancreas. Apud cells (diseases); Endocrinology & Metabolism; Endocrinopathies; Epidemiology; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; France - epidemiology; Humans; Hypertension - epidemiology; Internal Medicine; Male; Mass Screening - methods; Medical sciences; Middle Aged; Obesity - blood; Obesity - complications; Obesity - epidemiology; Pneumology; Prevalence; Prévalence; Quality of Life; Respiratory system : syndromes and miscellaneous diseases; Risk Factors; Sex Distribution; Sleep Apnea, Obstructive - blood; Sleep Apnea, Obstructive - complications; Sleep Apnea, Obstructive - diagnosis; Sleep Apnea, Obstructive - epidemiology; Sleep apneoa; Snoring - epidemiology; Social Class; Surveys and Questionnaires; Type 2 diabetes; Épidémiologie
• ISSN: 1262-3636; 1878-1780
• DOI: 10.1016/j.diabet.2012.10.004

Abstract Aim This study estimated the prevalence of symptoms evocative of obstructive sleep apneoa (OSA) in patients with type 2 diabetes and the proportion of those with evidence of a previous diagnosis or diagnostic procedure. Methods In ENTRED 2007, 8926 people reimbursed for at least three antidiabetic agents within the last 12 months were randomly selected, and 3894 answered a self-administered questionnaire. Symptoms evocative of OSA were defined as frequent snoring with excessive daytime sleepiness and/or witnessed sleep apneoa. Patients were considered to have evidence of a previous diagnostic procedure if they reported an OSA diagnosis or had a sleep recording done, or if a sleep recording was found in the hospital discharge or medical claims database, or if they were currently being treated with nocturnal ventilation. Results The patients’ mean age was 66 years. Around 8.5% reported being diagnosed with OSA, 4.2% were treated with nocturnal ventilation and 16% had symptoms evocative of OSA. Being male, obesity, high blood pressure, insulin treatment, living with a partner, lower educational level and financial difficulties were all associated with symptoms suggestive of OSA. Overall, 13% had evidence of a previous diagnostic procedure, and the rate was 35% among those with symptoms evocative of OSA. Conclusion OSA is underdiagnosed in French diabetic patients, while the prevalence of symptoms is high. Only 13% of the study population and 35% of those with symptoms suggestive of OSA had benefited from a diagnostic procedure. It is of the utmost importance to better diagnose OSA in the diabetic population.