Diabetes Metab J.  2019 Apr;43(2):144-155. 10.4093/dmj.2018.0256.

Metabolic Consequences of Obstructive Sleep Apnea Especially Pertaining to Diabetes Mellitus and Insulin Sensitivity

Affiliations
  • 1Epidemiologic Research and Information Center, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA.
  • 2Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA.
  • 3Department of Endocrinology and Metabolism, National Health Insurance Service Ilsan Hospital, Goyang, Korea.
  • 4Sleep Medicine Section, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA, USA.
  • 5Division of Metabolism, Endocrinology and Nutrition, Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA.
  • 6Department of Neurology, Chonbuk National University Medical School, Jeonju, Korea. iory252@naver.com

Abstract

Obstructive sleep apnea (OSA) and diabetes has been known to be closely related to each other and both diseases impact highly on the public health. There are many evidence of reports that OSA is associated with diabetes with a bidirectional correlation. A possible causal mechanism of OSA to diabetes is intermittent hypoxemia and diabetes to OSA is microvascular complication. However, OSA and diabetes have a high prevalence rate in public and shares the common overlap characteristic and risk factors such as age, obesity, and metabolic syndrome that make it difficult to establish the exact pathophysiologic mechanism between them. In addition, studies demonstrating that treatment of OSA may help prevent diabetes or improve glycemic control have not shown convincing result but have become a great field of interest research. This review outlines the bidirectional correlation between OSA and diabetes and explore the pathophysiologic mechanisms by approaching their basic etiologies.

Keyword

Diabetes mellitus; Insulin resistance; Obesity; Sleep apnea syndromes

MeSH Terms

Anoxia
Diabetes Mellitus*
Insulin Resistance*
Insulin*
Obesity
Prevalence
Public Health
Risk Factors
Sleep Apnea Syndromes
Sleep Apnea, Obstructive*
Insulin

Figure

  • Fig. 1 Proposed interaction of obstructive sleep apnea (OSA) and diabetes. RERA, respiratory effort related arousal; DM, diabetes mellitus.


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