Continuous Positive Airway Pressure Treatment, Glycemia, and Diabetes Risk in Obstructive Sleep Apnea and Comorbid Cardiovascular Disease

• DOI: 10.2337/dc19-2006
• Publication Date: 2020-04-15T03:05:17Z
• Authors: Kelly A. Loffler; Emma Heeley; Ruth Freed; Rosie Meng; Lia R. Bittencourt; Carolina C. Gonza...; Rui Chen; Michael Hlavac; Zhihong Liu; Geraldo Lorenzi-F...; Yuanming Luo; Nigel McArdle; Sutapa Mukherjee; Hooi Shan Yap; Xilong Zhang; Lyle J. Palmer; Craig S. Anderson; R. Doug McEvoy; Luciano F. Drager; ; Maree Barnes; Fengchun Yu; Xiaomei Meng; Wei Liu; Xinping Chen; Xiaomei Tang; Gaohui Xiao; Maolin He; Jingjing Liu; Matt Naughton; Michelle Hooy; Sophie Yorkston; Michael Hlavac; Michael James Epton; Malina Kate Storer; Julie Margaret Cook; Alastair Corbett; Rosie Portley; Ben Brockway; Jan Cowan; D. Robin Taylor; Emma Cox; Rochelle Palmay; Alan Young; Sue Del Sasso; Irina Shinkarksy; Ilana Shinkarksy; Francis Thien; Denise O’Driscoll; Angela Anniss; Wei Wang; Hui Shen; Derek Chew; Frances Kissajukian; Kate Luscombe; Fiona Wollaston; Zhihong Liu; Qiong Ou; Baoliang Du; Yanxia Wang; Yanhua Guo; Wei Dong; Lixin Wu; Kunlun Yu; Shengli Wang; Junyan Shi; Luciano Drager; Gabriela A. Souza; Daniel B.C. Queiróz; Katherine Ferrier; Judy Dewar; Ria Kleintjes; Jo Kovacs; Angela Campbell; Alister Neill; Yuechun Li; Xiue Li; Ruichun Pan; Hui Xue; Celso Amodeo; Juliana Silva; Renata Depizzol; Dalete de Andrade; Adriana Bertolami; Carolina Gonzaga; Geraldo Lorenzi-F...; Gabriela A. Souza; Daniel B.C. Queiróz; Lia Bittencourt; Carolina Ferreira; Madga Bignotto; Zhiqing Pan; Yu Dou; Meiyu Zhu; Gan Lu; Margaret Arstall; William Jeffries; Naomi Lamberts; Garun Hamilton; Joanne McKenzie; Xiuwei Zhang; Yi Xiao; Rong Huang; Doug McEvoy; Nick Antic; Denzil Paul; Amanda McKenna; Craig Anderson; Candice Delcourt; Cheryl Carcel; Elizabeth Ray; Theodora Paraskev...; Sabrina Small; Huili Zhu; Yulu Liang; Min Li; Xinbing Liu; Minpeng Wang; Jiangtao Lin; YiMing Li; Neil Graham; Mary Elizabeth Mo...; Li’e Wu; Xia Guo; Junping Wu; Zhendong Li; Xiaohua Xu; Yuangming Luo; Zhihui Qiu; Xilong Zhang; Chong Li; Wanda Peng; Guocui Zhen; Jian Hong Liu; James Douglas; Nicola Dunn; Darren Walters; Ling Lan; Jane Mikli; Andrew Wong; Deanne Curtin; Jan Robinson; Liwen Tai; Huijuan Wang; Rui Chen; Yanqiu Sun; Yanyu He; Bei Wang; Zhuda Liu; Hui Zhao; Xiaoling Gao; Yanfeng Fan; Hanqiao Wang; Cat Chang; Christine Tuffery; Sandra Hopping; Nigel McArdle; Sutapa Mukherjee; Bernadett Boeing; David Hillman; Siobhan Clare Rea; Xuejun Guo; Lianping Ren; Jinyuan Sun; Yiping Sun; Guangyue Qin; Shanqun Li; Wenjing Li; Xiaodan Wu; Jing Zhou; Hong Jiang; Laura Bandick; Michaela O'Keefe; Jeremy Mercer; Mark Jurisevic; Samantha Mead; Emma Heeley; Ruth Freed; Tina Cheung; Natalie Espinosa; Sarah Leighton; Tara Sasse; Michelle Leroux; Shu Ying; Yuehan Zheng; Wei Wei; Hongyu Zhang; Jing Zhou; Haijing Jia; Meng Zhang; Buliang Cui; Hua Deng; Aiwu Song; Doug McEvoy; Craig Anderson; Ron Grunstein; Jan Hedner; Shaoguang Huang; Geraldo Lorenzi-F...; Bruce Neal; Lyle Palmer; Susan Redline; Jiguang Wang; Nanshan Zhong
• Keywords: Blood Glucose; Male; Comparative Effectiveness Research; Aging; Sleep Apnea; Clinical Trials and Supportive Activities; 610; 32 Biomedical and Clinical Sciences; Comorbidity; Glycemic Control; Cardiovascular; Prediabetic State; 03 medical and health sciences; anzsrc-for: 32 Biomedical and Clinical Sciences; 0302 clinical medicine; Clinical Research; Risk Factors; 616; Diabetes Mellitus; Humans; Obesity; Lung; SAVE Substudy Investigators; Aged; Glycated Hemoglobin; Sleep Apnea, Obstructive; Continuous Positive Airway Pressure; Obstructive; anzsrc-for: 42 Health sciences; Prevention; Diabetes; anzsrc-for: 3201 Cardiovascular Medicine and Haematology; 3 Good Health and Well Being; Standard of Care; Middle Aged; 3. Good health; Treatment Adherence and Compliance; Heart Disease; anzsrc-for: 11 Medical and Health Sciences; Diabetes Mellitus, Type 2; 3201 Cardiovascular Medicine and Haematology; Cardiovascular Diseases; Respiratory; Female; Sleep Research; Type 2

Despite evidence of a relationship among obstructive sleep apnea (OSA), metabolic dysregulation, and diabetes, it is uncertain whether OSA treatment can improve parameters. We sought to determine effects long-term continuous positive airway pressure (CPAP) on glycemic control diabetes risk in patients with cardiovascular disease (CVD) OSA.Blood, medical history, personal data were collected substudy 888 participants the Sleep Apnea cardioVascular Endpoints (SAVE) trial which stable CVD randomized receive CPAP plus usual care, or care alone. Serum glucose glycated hemoglobin A1c (HbA1c) measured at baseline, 6 months, 2 4 years incident diagnoses recorded.Median follow-up was 4.3 years. In those preexisting (n = 274), there no significant difference between groups serum glucose, HbA1c, antidiabetic medications during follow-up. There also between-group differences prediabetes 452) new diabetes. Interaction testing suggested that women did poorly group, while their counterparts therapy remained stable.Among established OSA, we found over several affects standard-of-care treatment. The potential differential effect according sex deserves further investigation.