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Sleep Disorder Treatment Also Aids Diabetics

Lower glucose reduces risk for other complications of disease

MONDAY, Feb. 28, 2005 (HealthDay News) -- Type 2 diabetics who suffer from sleep apnea may be able to significantly lower their glucose levels if they treat their breathing disorder, University of Illinois at Chicago researchers have found.

This is important, doctors say, because by reducing glucose levels, diabetics can cut their attendant risks for stroke, heart attack and kidney disease by approximately 6 percent to 12 percent.

"This is of great clinical significance," said study author Dr. James Herdegen, medical director of the university's Center for Sleep and Ventilatory Disorders.

The findings appear in the Feb. 28 issue of the Archives of Internal Medicine.

In the small study, 25 type 2 diabetics who had been diagnosed with sleep apnea underwent standard treatment for the condition.

The patients were mostly male, with an average age of 50, and were severely obese, with an average body mass index (BMI) of 42. Obesity is a known risk factor for diabetes as well as sleep apnea, and diabetics are nine times more likely to have sleep apnea than people without the disease, Herdegen said.

The participants underwent the standard treatment for the sleep apnea, called continuous positive airway pressure (CPAP), which includes going to bed wearing a mask over the nose or nostrils that is attached to a machine that blows air through the upper respiratory tract, keeping the back of the throat from closing. Using the mask for a minimum of fours hours a night is needed for effective treatment, said Herdegen.

Using that technique, the participants' overall hemoglobin levels were reduced by 0.5 percent, which is very similar to the reduction achieved by medication, Herdegen said.

Further, their average glucose levels an hour after eating, a key measurement when monitoring diabetes, dropped from 190 mg/dl to 135 mg/dl. Levels between 140 mg/dl and 160 mg/dl are considered manageable for diabetic patients. In those without diabetes, levels between 70 mg/dl and 120 mg/dl are considered healthy.

The strong results from this study indicate the need for a larger study to measure these effects, Herdegen said, but also suggest that screening for sleep apnea should be a regular part of treatment for type 2 diabetics.

"This study illustrates the fact that type 2 diabetics with a risk for sleep apnea should be screened, because we have a very effective treatment that will help them feel better, and improve their diabetes management," he said.

"This is a very good paper, and takes the known research about diabetes and sleep apnea one step further," said Dr. Meir Kryger, director of the Sleep Disorders Center at St. Boniface Hospital in Winnipeg, Canada, and author of A Woman's Guide to Sleep Disorders.

It has been established that sleep apnea impairs the body's ability to properly deal with glucose, but this work shows that treating sleep apnea improves the patient's glucose metabolism, he added.

Herdegen noted that because the sleep apnea standard treatment is complicated, compliance is uneven, about 50 percent to 60 percent. But, he said, the quality of the machines are improving and masks are becoming more comfortable.

And, he added, for diabetics who have sleep apnea, "the treatment brings not only short-term results but long-term benefits."

More information

For information about sleep apnea, visit the National Heart, Blood, and Lung Institute.

SOURCES: James Herdegen, M.D., medical director, Center for Sleep and Ventilatory Disorders, University of Illinois, Chicago; Meir Kryger, M.D., director, Sleep Disorders Center, St. Boniface Hospital, Winnipeg, Canada, and professor, medicine, University of Manitoba, Canada; Feb. 28, 2005, Archives of Internal Medicine
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