That’s the chief finding of new research presented this week at an international meeting of the American Thoracic Society in Philadelphia. The study, conducted by researchers at McGill University in Montreal, showed the use of so-called CPAP treatment — short for continuous positive airway pressure — not only helped alleviate apnea in a group of prediabetic individuals (with borderline high blood sugar), but also led to marked improvements in glucose levels and their bodies’ ability to process insulin.
“Sleep apnea, a condition associated with breathing disturbances during sleep is known to be associated with abnormalities in glucose metabolism, but whether treatment of sleep apnea has any beneficial effects on glucose metabolism is still under investigation,” said lead researcher Sushmita Pamidi, M.D., of the Department of Medicine at McGill.
“We have studied patients with sleep apnea and prediabetes, a condition defined as higher than normal blood glucose levels but not high enough to be considered diabetes. We found that optimal treatment of sleep apnea with [CPAP] for two weeks led to significant improvements in glucose levels following an oral glucose challenge without affecting insulin secretion, suggesting an improvement in insulin sensitivity."
Insulin is a hormone produced in the pancreas that regulates the metabolism of glucose in the body. Insulin resistance is a condition in which normal amounts of insulin are not adequate to produce a proper response to glucose. Low insulin sensitivity, a measure of how sensitive a person's body is to the effects of insulin, is associated with the development of type 2 diabetes.
Up to two-thirds of type 2 diabetic patients suffer from sleep apnea, the researchers noted. The main treatment for apnea is CPAP, in which a machine delivers air at a regular pressure through a breathing tube connected to a facemask to keep the upper airway open and prevent breathing problems during sleep.
The McGill study involved 39 adults with apnea and prediabetes who received either CPAP treatment or a dummy placebo tablet. Oral glucose tolerance tests, measuring the body's ability to use glucose, determined those who underwent CPAP treatment had marked glucose improvements.
“Effective treatment of [apnea] is known to have a positive impact on a number of important health outcomes and in our study we observed beneficial effects on glucose metabolism,” said co-researcher Esra Tasali, M.D., assistant professor of pulmonary and critical care medicine at the University of Chicago.
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Dr. Tasali suggested further studies should seek to determine if CPAP treatment should be a first-line strategy to prevent or delay the development of type 2 diabetes.
“Our study adds to the current literature by demonstrating that CPAP treatment of sleep apnea in patients at risk for developing diabetes may lower this risk, and an assessment for sleep apnea may be appropriate as part of the clinical evaluation of patients with prediabetes," said Dr. Pamidi.
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