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Obstructive sleep apnea as a risk factor for type 2 diabetes mellitus

Authors Rajan P, Greenberg H

Received 20 June 2015

Accepted for publication 10 August 2015

Published 5 October 2015 Volume 2015:7 Pages 113—125

DOI https://doi.org/10.2147/NSS.S90835

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Editor who approved publication: Professor Steven A Shea


Preethi Rajan, Harly Greenberg

Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Hofstra-North Shore LIJ School of Medicine, New Hyde Park, NY, USA

Abstract: Obstructive sleep apnea (OSA) is independently associated with cardiovascular and cardiometabolic risk in several large epidemiologic studies. OSA leads to several physiologic disturbances such as intermittent hypoxia, sleep fragmentation, and increase in autonomic tone. These disturbances have been associated with insulin resistance and type 2 diabetes mellitus (T2DM) in animal and human studies. Studies also suggest a bidirectional relationship between OSA and T2DM whereby T2DM itself might contribute to the features of OSA. Moreover, successful treatment of OSA may reduce these risks, although this is controversial. The purpose of this article is to review 1) the links and bidirectional associations between OSA and T2DM; 2) the pathogenic mechanisms that might link these two disease states; 3) the role of continuous positive airway pressure therapy in improving glucose tolerance, sensitivity, and resistance; and 4) the implications for clinical practice.

Keywords: Insulin resistance, metabolic syndrome, sleep disordered breathing, intermittent hypoxia

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