Study of Obstructive Sleep Apnea in Obese Patients with Type 2 Diabetes Mellitus
Published: June 1, 2020 | DOI: https://doi.org/10.7860/JCDR/2020/44041.13746
GN Srivastava, Mrityunjay Sharma, SK Singh
1. Professor and Head, Department of TB and Respiratory Diseases, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India.
2. Junior Resident (3rd year), Department of TB and Respiratory Diseases, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India.
3. Professor and Head, Department of Endocrinology and Metabolism, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India.
Correspondence
Dr. Mrityunjay Sharma,
Room-143, Sushruta Hostel, Trauma Centre, Banaras Hindu University, Varanasi, Uttar Pradesh, India.
E-mail: msmrityu@gmail.com
Introduction: Obstructive Sleep Apnea (OSA), characterised by repetitive episodes of breathing cessation due to upper airway collapse is associated with significant morbidity and mortality. Type 2 Diabetes Mellitus (T2DM) and OSA are two common, chronic conditions that are associated with each other, in a bidirectional relationship and both share common risk factor obesity.
Aim: To study the prevalence of OSA in obese patients with T2DM.
Materials and Methods: Unattended polysomnography was performed in 50 obese (BMI >30 Kg/m2 ) and T2DM patients (symptoms of diabetes plus random blood glucose concentration ≥200 mg/dL and/or fasting plasma glucose ≥126 mg/dL, and/ or Haemoglobin A1c (HbA1c) ≥6.5%, and/or 2-hour plasma glucose ≥200 mg/dL). Descriptive statistical methods were used such as computing percentage, mean, standard deviation and correlations.
Results: Over 88% (N=44) of participants i.e., 64% male (N=32) and 24% female (N=12) with obesity and T2DM (Mean HbA1c 8.87±1.88) had OSA with an Apnea-Hypopnea Index (AHI) ≥5 events/h. The mean AHI was 33.57±24.88 events/h in males and 24.33±18.75 events/h in females. A total of 32% (N=16) of the participants had mild OSA (AHI 5-14), 26% (N=13) had moderate OSA (AHI 15-30), and 30% had severe OSA (AHI ≥30) (N=15). 28 out of 34 class I obese (BMI- 30-34.99 kg/m2 ) with T2DM, 12 out of 12 class II obese (BMI- 35-39.99 kg/m2 ) with T2DM and 4 out of 4 class III obese (BMI≥40 kg/m2 ) and T2DM patients had OSA (p-value=0.001).
Conclusion: There was an exceedingly high prevalence of undiagnosed OSA in obese patients with T2DM.
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