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. 2023 Jan 18:13:1020617.
doi: 10.3389/fendo.2022.1020617. eCollection 2022.

Effect of nocturnal hypoxemia on glycemic control among diabetic Saudi patients presenting with obstructive sleep apnea

Mahmoud I Mahmoud  1   2 , Raed K Alotaibi  3 , Rayyan Almusally  4 , Hanaa Shafiek  2 , Yasir Elamin  1 , Ziad Alhaj  1   5 , Waleed AlBaker  4 , Alaeldin Elfaki  1   5 , Hatem Qutub  4 , Suha J Albahrani  6 , Fatima M Alabdrabalnabi  4   7 , Zahra A Al Saeed  4   7 , Reem Al Argan  4 , Fatima Al Rubaish  4 , Yousef D Alqurashi  8 , Noor-Ahmed Jatoi  4 , Abdullah H Alharmaly  4   9 , Zainab Z Almubarak  4 , Abir H Al Said  4 , Nada Albahrani  10
Affiliations

Effect of nocturnal hypoxemia on glycemic control among diabetic Saudi patients presenting with obstructive sleep apnea

Mahmoud I Mahmoud et al. Front Endocrinol (Lausanne). .

Abstract

Background: Obstructive sleep apnea (OSA) is a prevalent disease that is associated with an increased incidence of type II diabetes mellitus (DM) if left untreated. We aimed to determine the association between glycosylated hemoglobin (HbA1c) levels and both nocturnal hypoxemia and apnea-hypopnea index (AHI) among a Saudi patients with OSA.

Methods: A cross-sectional study that enrolled 103 adult patients diagnosed with DM and confirmed to have OSA by full night attended polysomnography between 2018 and 2021. Those who presented with acute illness, chronic obstructive pulmonary disease (COPD)/restrictive lung diseases causing sleep-related hypoxemia, or no available HbA1c level within 6 months before polysomnography were excluded from the study. Univariate and multivariate linear regression analyses between HbA1c levels and parameters of interest were tested.

Results: Sixty-seven (65%) of the studied population had uncontrolled DM (HbA1c ≥7%). In univariate regression analysis, there was a significant positive association between HbA1c, and sleep time spent with an oxygen saturation below 90% (T90), female gender, and body mass index (BMI) (p<0.05) but not AHI, or associated comorbidities (p>0.05). In the multivariate analysis, HbA1c was positively associated with increasing T90 (p<0.05), and ODI (p<0.05), but not with AHI (p>0.05).

Conclusion: Nocturnal hypoxemia could be an important factor affecting glycemic control in patients with OSA suffering from DM irrespective of the severity of both diseases.

Keywords: T90; apnea/hypopnea index; glycosylated hemoglobin; hypoxia; nocturnal hypoxemia; obstructive sleep apnea.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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Figure 1
Patient flowchart.
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