Therapy Improves Insulin
Sensitivity in Obstructive Sleep Apnea
Getting a good night’s sleep is important
in controlling diabetes.
Continuous positive airway pressure treatment
can rapidly improve insulin sensitivity in
patients with obstructive sleep apnea syndrome.
"The obstructive sleep apnea syndrome is
typically associated with conditions known to
increase insulin resistance as hypertension,
obesity, and diabetes," Dr. Igor A. Harsch,
of Friedrich-Alexander University, Erlangen, and
colleagues report in the January 15th issue of
the American Journal of Respiratory and Critical
Care Medicine.
The investigators examined whether
obstructive sleep apnea syndrome is an
independent risk factor for increased insulin
resistance, and if continuous positive airway
pressure treatment can improve insulin
sensitivity.
Forty patients with an apnea-hypopnea index
greater than 20 were treated with continuous
positive airway pressure. The team performed
hyperinsulinemic euglycemic clamp studies
before, 2 days after, and 3 months after
treatment.
They found that insulin sensitivity
significantly increased from 5.75 micromol/kg/min
to 6.79 micromol/kg/min (p = 0.003) after 2
days. Insulin sensitivity remained stable after
3 months of treatment in the 31 patients
available for follow-up.
Patients with body mass index less than 30
kg/m squared had a much greater improvement in
insulin sensitivity after 2 days than did more
obese patients. After adjusting for age, apnea-hypopnea
index and hypertension, BMI of less than 30 was
an independent predictor of improved insulin
sensitivity.
"The improved insulin sensitivity after
2 nights of treatment may reflect a decreasing
sympathetic activity, indicating that sleep
apnea is an independent risk factor for
increased insulin resistance," Dr. Harsch
and colleagues note. Am J Respir Crit Care
Med 2004;169:156-162.
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FACT: The
impact of exercise on heart disease – The
risk of heart disease increases, not among those
with high caloric intake, but rather those that
have the least amount of physical activity.
Research supports that those who ate the lowest
calories, had the least physical activity, and
were overweight or obese, had a 55% greater
mortality rate than those who ate more calories,
were of normal weight, and partook in the
greatest amount of physical activity. AHA
2004
