Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2014 Aug 29;10(4):637-42.
doi: 10.5114/aoms.2014.44854.

Effects of continuous positive airway pressure treatment on glycaemic control and insulin sensitivity in patients with obstructive sleep apnoea and type 2 diabetes: a meta-analysis

Liang Chen  1 , Jian-Hao Pei  1 , Hong-Mei Chen  1
Affiliations
Review

Effects of continuous positive airway pressure treatment on glycaemic control and insulin sensitivity in patients with obstructive sleep apnoea and type 2 diabetes: a meta-analysis

Liang Chen et al. Arch Med Sci. .

Abstract

Introduction: Obstructive sleep apnoea (OSA) is a prevalent disorder characterised by repetitive upper-airway obstruction during sleep, and it is associated with type 2 diabetes. Continuous positive airway pressure (CPAP) is the primary treatment for OSA. Prior studies investigating whether CPAP can improve insulin resistance or glucose control in OSA patients have resulted in conflicting findings. This meta-analysis investigated whether CPAP treatment could improve glucose metabolism and insulin resistance in patients with OSA and type 2 diabetes.

Material and methods: We performed a systematic literature search using Medline, Cochrane, EMBASE, and Google Scholar databases for randomised controlled prospective studies that investigated the effect of CPAP on glycaemic control or insulin sensitivity in subjects with type 2 diabetes.

Results: The combined standard (STD) paired difference in mean change in the levels of glycated haemoglobin (HbA1c) was -0.073% (standard error (SE): 0.126), indicating that CPAP treatment did not alter HbA1c levels. The combined STD paired difference in mean change of insulin sensitivity was observed as 0.552 µmol/kg • min (SE = 0.196) and indicated insulin sensitivity significantly increased with CPAP treatment (p = 0.005).

Conclusions: We found that the CPAP treatment did not alter HbA1c levels but did significantly improve insulin resistance, indicating treating OSA can positively impact the symptoms of type 2 diabetes.

Keywords: glycaemic control; insulin resistance; obstructive airway apnoea; positive airway pressure.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Flow chart for study selection
Figure 2
Figure 2
Forest plot of major outcomes, (A) HbA1c level and (B) insulin sensitivity before and after CPAP treatment Std – standardised, 95% CI – 95% confidence interval, ISI – insulin sensitivity
Figure 3
Figure 3
Sensitivity analysis for the influence of individual studies on pooled estimate by means of leave-one-out for HbA1c level before and after CPAP treatment Std – standardised, 95% CI – 95% confidence interval, ISI – insulin sensitivity
Figure 4
Figure 4
Funnel plot of HbA1c level
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Ip MS, Lam B, Ng MM, Lam WK, Tsang KW, Lam KS. Obstructive sleep apnea is independently associated with insulin resistance. Am J Respir Crit Care Med. 2002;165:670–6. - PubMed
    1. Punjabi NM, Beamer BA. Alterations in glucose disposal in sleep-disordered breathing. Am J Respir Crit Care Med. 2009;179:235–40. - PMC - PubMed
    1. Punjabi NM, Shahar E, Redline S, et al. Sleep-disordered breathing, glucose intolerance, and insulin resistance: the Sleep Heart Health Study. Am J Epidemiol. 2004;160:521–30. - PubMed
    1. Punjabi NM, Sorkin JD, Katzel LI, Goldberg AP, Schwartz AR, Smith PL. Sleep-disordered breathing and insulin resistance in middle-aged and overweight men. Am J Respir Crit Care Med. 2002;165:677–82. - PubMed
    1. Levy P, Bonsignore MR, Eckel J. Sleep, sleep-disordered breathing and metabolic consequences. Eur Respir J. 2009;34:243–60. - PubMed