What is Endocrinology - What two primary pathways underlie the emergence of impaired glucose metabolism in sleep apnea patients?
Airflow decrease, which is the defining feature of OSA, is frequently linked to intermittent hypoxemia, fragmented sleep, and SNS stimulation. Independent of SNS activity, intermittent hypoxemia has been demonstrated to alter insulin sensitivity in animal experiments. Additionally, it has been demonstrated that in overweight to mildly obese male non-diabetic subjects, every 4% drop in oxygen saturation is connected to an odds ratio of nearly 2 for deteriorated glucose tolerance. An impaired glucose metabolism has been linked to fragmented sleep. In one study of healthy adults, selective SWS suppression without a reduction in total sleep time was linked to a roughly 25% reduction in insulin sensitivity. This finding implies that the increased frequency of DM2 in elderly and obese people may be related to their low levels of SWS. Mild OSA was linked to a mean HbA1C of 7.22% and severe OSA with a HbA1C of about 9.42% in a study of consecutive people with DM2, aged 41 to 77, with a BMI of 20 to 57 kg/m2. The severity of OSA as measured by the AHI linked with higher mean HbA1C values after controlling for age, gender, race, BMI, number of diabetic medications, degree of exercise, years with diabetes, and total sleep time.
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