OSA and glucose metabolism: OSA and dysglycemia have similar risk factors (namely obesity) and hence it is not surprising that these conditions co-exist. However, not all obese patients have both conditions and many patients have one and not the other. Hence, understanding this association and the mechanisms that underpin this relationship is important to understand the pathogenesis of OSA and T2DM. There are many studies that have examined the association between snoring, as a surrogate marker of OSA, and different aspects of glucose metabolism; here, however, we will mainly focus on studies that validated the presence and severity of OSA using more accurate methods.

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Guest Post by David Kliff, Editor, Diabetic Investor

As I left Vienna after attending the 11th International Conference on Advanced Technologies & Treatments for Diabetes, my thoughts turned to what does this all mean, what was the most significant takeaway? By far the most significant development coming out of ATTD is the long quest to have a REAL closed-loop insulin delivery system is no longer a pipe dream. This is going to happen and for once I believe it will happen in my lifetime. It is difficult to overstate the power of the data I witnessed. The reality here is that some very smart people have come a very long way.

According to a recent study, which one of the following diabetes therapies carries a lower risk for adverse cardiovascular (CV) events? 1. Nonspecific, long-acting sulfonylureas (eg, glyburide and glimepiride) 2. Specific, short-acting sulfonylureas (eg, glipizide, tolbutamide) 3. CV risk does not differ between these agents Follow the link for the answer.

Do you provide any kind of exercise program for your patients? Follow the link to see how you compare to your colleagues.

OSA pathophysiology: OSA is a very complex disorder, and although obesity and fat deposition around the neck plays an important role, there are many other important players that contribute to the development of this condition. The human upper airway is a unique multipurpose structure involved in performing a variety of tasks such as speech, swallowing, and the passage of air for breathing. The airway, therefore, is composed of numerous muscles and soft tissue but lacks rigid or bony support. Most notably, it contains a collapsible portion that extends from the hard palate to the larynx, which allows the upper airway to change shape and momentarily for speech and swallowing during wakefulness; but this feature also provides the opportunity for collapse at inopportune times such as during sleep.