Please use this identifier to cite or link to this item: https://observatorio.fm.usp.br/handle/OPI/36751
Title: Continuous Positive Airway Pressure Treatment, Glycemia, and Diabetes Risk in Obstructive Sleep Apnea and Comorbid Cardiovascular Disease
Authors: LOFFLER, Kelly A.HEELEY, EmmaFREED, RuthMENG, RosieBITTENCOURT, Lia R.CARVALHO, Carolina C. GonzagaCHEN, RuiHLAVAC, MichaelLIU, ZhihongLORENZI-FILHO, GeraldoLUO, YuanmingMCARDLE, NigelMUKHERJEE, SutapaYAP, Hooi ShanZHANG, XilongPALMER, Lyle J.ANDERSON, Craig S.MCEVOY, R. DougDRAGER, Luciano F.
Citation: DIABETES CARE, v.43, n.8, p.1859-1867, 2020
Abstract: OBJECTIVE Despite evidence of a relationship among obstructive sleep apnea (OSA), metabolic dysregulation, and diabetes, it is uncertain whether OSA treatment can improve metabolic parameters. We sought to determine effects of long-term continuous positive airway pressure (CPAP) treatment on glycemic control and diabetes risk in patients with cardiovascular disease (CVD) and OSA. RESEARCH DESIGN AND METHODS Blood, medical history, and personal data were collected in a substudy of 888 participants in the Sleep Apnea cardioVascular Endpoints (SAVE) trial in which patients with OSA and stable CVD were randomized to receive CPAP plus usual care, or usual care alone. Serum glucose and glycated hemoglobin A(1c)(HbA(1c)) were measured at baseline, 6 months, and 2 and 4 years and incident diabetes diagnoses recorded. RESULTS Median follow-up was 4.3 years. In those with preexisting diabetes (n= 274), there was no significant difference between the CPAP and usual care groups in serum glucose, HbA(1c), or antidiabetic medications during follow-up. There were also no significant between-group differences in participants with prediabetes (n= 452) or new diagnoses of diabetes. Interaction testing suggested that women with diabetes did poorly in the usual care group, while their counterparts on CPAP therapy remained stable. CONCLUSIONS Among patients with established CVD and OSA, we found no evidence that CPAP therapy over several years affects glycemic control in those with diabetes or prediabetes or diabetes risk over standard-of-care treatment. The potential differential effect according to sex deserves further investigation.
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Artigos e Materiais de Revistas Científicas - FM/MCM
Departamento de Clínica Médica - FM/MCM

Artigos e Materiais de Revistas Científicas - FM/MCP
Departamento de Cardio-Pneumologia - FM/MCP

Artigos e Materiais de Revistas Científicas - HC/InCor
Instituto do Coração - HC/InCor

Artigos e Materiais de Revistas Científicas - LIM/63
LIM/63 - Laboratório de Investigação Médica em Sono

Artigos e Materiais de Revistas Científicas - ODS/03
ODS/03 - Saúde e bem-estar


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